Online Form - Community Support: I need assistance

Sometimes we all need help especially if you don't have any local family members or friends.

If you do need help, please don't hesitate to complete the form below and we will contact you shortly. Alternatively please contact the Shire of Cunderdin Office on 9635 2700.

My name is:

I live at:

My phone number is:

HOW CAN WE HELP YOU?

Please indicate how we can help you by answering the following questions:

I need a friendly phone call

YesNo

I need help with pick up/drop off of supplies

YesNo

What else can we help with?

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