CCDN Forms & Applications

This is your Services Page. On this page, you will find CCDN Applications for Services, Referral Forms, and Food Reservation Form. 

Signing a Contract

Life Services is our program that provides essential needs. Click on the name at the top to obtain the application

2

Community Food Hubs provide up to 40-80lbs of food per month.  Families who sign up can pick up 2 times per month at any of our sites.  We ask that you register at the site you are picking up at. Click on the Food Hub you would like to register for.

Food Hub # 1 Center Point

Food Hub # 2 East Lake United Methodist Church

Food Hub # 3 Woodlawn United Methodist Church

Food Hub # 4 Bessemer Shady Grove Baptist Church

Food Hub # 5 Birmingham Public Library Titusville

Food Hub # 6  First SDA Church Bessemer

Food Hub # 7 Fountain Heights Old Sardis Baptist Church

Food Hub # 8 Kingston Community (Comming Soon)

Food Hub # 9 Bessemer Housing Authority

 

3

CCDN Partners can refer clients to any of our services.  To refer a client click on the referral link above. Please complete the referral form below. Please note financial assistance is only in referral format. We do not have direct funds to pay on accounts. We will assist by connecting to partner agencies. Referrals who have received financial assistance from Community Action or Serving You Ministries within the past 6 months may not qualify for financial referral assistance. We will evaluate on a case-by-case basis.

4

Fill out the form carefully for registration. This application is for up to 3 school-aged children. If there are multiple children past 3 you will need to complete a second application. School supplies will be distributed on Life Service Thursdays 2nd and 4th Thursday of each month 1:00 pm-3:00 pm. You must register prior to receiving school supplies, NO EXCEPTIONS!