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Agency
Referral
Please complete the form below to set up your Client's appointment.
Name:
Last Name:
Address:
City:
Zip code:
Phone #:
E-mail address:
Please add any comments or concerns:
Please choose a Day:
OR
Complete this section only if your Agency is verified with the Dublin Furniture Banc
Agency Name:
Agency Address:
Caseworker:
Phone #:
E-mail Address:
Client Info Needed
Agency Info Needed
Agencies Only
Things to bring if you are not using our delivery service.
Truck
Tarp
Rope
Friends
Family
to load your truck.
Please make sure you have all these items in place, as we cannot reschedule your appointment if you do not have these items the day of you scheduled appointment. There are many families in need in Central Ohio that need our services and we are trying to help everyone in timely manner.
Thank you!
Dublin Furniture Banc.
HOME IS WHERE THE HEART IS... A PLACE WE ALL SHARE!
