MUM Request for Appointment

Use this form to request an appointment with MUM to apply for assistance. Someone will contact you during MUM’s office hours: 9 a.m. to 4 p.m. on Tuesday, Wednesday and Thursday.

Assistance Needed

What type of assistance are you seeking?(Required)

Select all that apply

Eviction Prevention

Utility Prevention

Prescription Drugs

Food Assistance

Your Contact Information

Name(Required)

First Last

Phone Number

Email Address

Address(Required)

Street Address City State ZIP Code

Phone

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Mid-County United Ministries (MUM)

Mid-County United Ministries (MUM)

MUM Provides Emergency Food and Assistance to People in Crisis

MUM Provides Emergency Food and Assistance to People in Crisis

KENSINGTON · SILVER SPRING · WHEATON · ROCKVILLE · ASPEN HILL

KENSINGTON · SILVER SPRING · WHEATON · ROCKVILLE · ASPEN HILL

Your cash donations make a real difference

MUM Request for Appointment

Assistance Needed

Your Contact Information