Form Vehicle Request – His Helping Hands Automotive

Vehicle Request Form

If you or someone you know is in need of a vehicle due to financial hardships or unforeseen circumstances, please fill out the following form.

All information will be kept confidential. Filling out this form does not guarantee the requested individual will receive a vehicle. However, notifying His Helping Hands of a potential recipient will allow us to consider the individual when we have a vehicle to offer.

If you would like to send us correspondence, please do so at the following address:

PO Box 94403

Oklahoma City, OK 73160

Phone:

(405) 641-5382

Email:

support@hhhauto.com

Name *

First

Last
Email Address *
Phone Number *
Drivers License Status *

Licensed and Current Licensed and Not Current Not Licensed Other (Describe Below)
Financial Assistance Request *

Partial Assistance Needed Full Assistance Needed
Vehicle Passenger Capacity Need *
Description of Financial Hardship *
Where did you hear about His Helping Hands?
Additional details about how you heard about us!

Vehicle Request Form

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