Resource Request Form – Fairfax Church

11451 Braddock Road, Fairfax VA 22030

Fairfax Resource Center Request Form

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Welcome! We are so happy you found the Fairfax Church Resource Center. We provide resources to community social service professionals working directly with families who need immediate support.

Each week our Resource Center distributes groceries, household essentials, kitchen essentials, hygiene bags, diapers and special requests to some of the most vulnerable children and families in Fairfax County.

If you are a professional and currently need to obtain resources for a family, we want to support you. Simply submit the form below and you will receive an email confirmation from us. If you have any other questions, please contact us at resourcecenter@fairfax.cc.

Professional Information(Required)

First Name Last Name

What type of agency do you work for?(Required)

You must work for a nonprofit, school, or government service agency.

HHS: Agency type(Required)

FACETS: Agency Type(Required)

FCPS: Division or School(Required)

Non Profit: Organization(Required)

FCPD: Unit, District(Required)

Which station do you work in?(Required)

What is the FACETS agency type?(Required)

What is the HHS agency type?(Required)

What is the name of the school?(Required)

What's the name of the Non Profit?(Required)

What is the best way to contact you for pickup confirmation?(Required)

Cell Phone Number(Required)

Professional Email Address(Required)

Donation Pick-up

The person picking up the donations should be the same professional filling out this form unless you specifically make other arrangements with the Resource Center team. We currently do not have a delivery system.

Select your pick-up date and time below:(Required)

Do you need to make other arrangements for donation pickup?(Required)

No, I will pick up the items at the date and time selected.

Yes, I need to make other arrangements.

Specifically, what other arrangements are you requesting? Someone from our team will reach out to you.

Volunteer Name(Required)

Volunteer Email Address(Required)

Social Worker Name(Required)

FY 2025 Income Limits Summary
Persons in Family	Extremely Low Income (30% MSA*)	Very Low Income (50% MSA*)	Low Income (80% MSA*)
1	$34,450	$57,400	$74,800
2	$39,350	$65,600	$85,450
3	$44,250	$73,800	$96,150
4	$49,150	$81,950	$106,800
5	$53,100	$88,550	$115,350
6	$57,050	$95,100	$123,900
7	$60,950	$101,650	$132,450
8+	$64,900	$108,200	$141,000

FAQs

Who are the professionals?

“Professional” is a broad definition for those in our community who work directly with families in crisis. This may include school and county social workers, teachers, police officers, parole counselors, resettlement agencies, the health department, counselors, doctors, nurses, among so many others. Professionals are working directly with people in difficult circumstances to help families maintain a sustainable living.

During the pandemic, we were inspired by so many professionals who were working outside the scope of their required job responsibilities to help families in crisis. We heard so many stories, from teachers buying groceries and dropping them off at students’ homes to counselors shopping on Christmas Eve, that we wanted to share the wealth of the financial burden to support professionals caring for these families.

What are the resources?

The resources in our center are meant for supplemental purposes and not as ongoing support services for families. The Northern Virginia area has numerous social service agencies and opportunities for families to get connected with professionals who can help. It is important for families to connect to these services so that they can work with a case worker toward sustainability.

Resources include groceries (perishables and non-perishables), hygiene items, household essentials, cleaning supplies, diapers and clothing.

How do requests work?

Let’s jump right to it. We are so excited to work with you!

First, complete the request form below with your professional name, professional email, agency, and cell phone.

Second, through the request form, we’ll ask for generic information about the family so we can pull together enough resources for the size and age range of the family. Next, we will ask you to let us know your availability to pick up the resources. All of these details will be confirmed over email/text before you arrive. Please make sure you receive this email/text before coming to the Resource Center.

Can Fairfax deliver to my clients?

No.We recognize that professionals hold relationship and trust with families, but not necessarily the budget to support all of their clients. We believe that providing professionals with supplemental resources relieves some of the stress so that you can better serve families toward sustainability. Therefore, we prefer that you pick up from our center which is open Monday through Thursday 9:00am – 5:00pm and Sunday mornings, by appointment. We can make arrangements for a delivery to be made to you per request in our form.

Fairfax Resource Center Request Form

Welcome! We are so happy you found the Fairfax Church Resource Center. We provide resources to community social service professionals working directly with families who need immediate support.

Donation Pick-up

Client Information: PLEASE DO NOT COMBINE REQUESTS ONTO ONE FORM. ONE REQUEST PER HOUSEHOLD.

Client Identifier

Family demographic breakdown for the ENTIRE household (Adult and Children)

How can we assist you today? Please check most immediate needs that apply.

Baby Food

Baby Formula

Diapers

Children's Clothing 0-16 Years

Is the family in need of children's clothing? We have an inventory of donated clothing. We cannot guarantee we have the sizes you need, but we would love to offer them to your families. Please indicate below if your family needs clothing.

Child #1

Child #2

Child #3

Child #4

Child #5

Family Coats

We have an inventory of donated coats. We cannot guarantee we have the sizes you need, but we would love to offer them to your families. Please indicate below if your family needs coats.

Additional Information

After you hit submit, you will receive a confirmation email that we received your request. Once your donation request is ready we will confirm pick up.

FAQs

Who are the professionals?

What are the resources?

How do requests work?

Can Fairfax deliver to my clients?

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