Request For Assistance Through United Way of East TN Highlands Please fill out the form below If you are unable to fill out the form or need to speak someone, please call Crystal Carter at 423-543-6975 Name* First Last County of Residence*Please ChooseCarterJohnsonWashingtonPhone*Email* Has your financial status been affected by COVID-19? Yes No If yes, please explainAre you open to free financial coaching? Yes No How many children live in your household? How many adults (18+) live in your household? Type of assistance requestedPlease ChooseGas CardFood CertificatesGas Card & Food CertificatesConsent* I agree to share the above information with United Way of East TN HighlandsYou must be willing to share your information with United Way of East TN Highlands to have your application reviewed.