Please check the service(s)/resources you are willing to volunteer or donate:

Contact Information:

Name:

Phone:

Email:

Construction & Clean-Up:

Repair/Reconstruction Labor

Clean-up labor

Materials/Supplies

Clean-Up Supplies

Other Construction & Clean-up

Please list or explain service:

Financial Donations:

One time donation

Amount:

Ongoing - for several months

Amount:

Number of Months:

Other Financial Donation

Amount:

Church:

Family:

Pastor:

Individual:

Housing:

Short-term in my home

Short-term in an apartment or second home

Permanent Housing

Pay for hotel or apartment

Amount willing to spend:

Length of stay:

Donation of Goods:

Food (non-perishables)

Clothing

Toys

School Supplies

Shoes/Sneakers

Water

Automobiles/Vehicles

Bedding/Linens

Household Supplies

Small electronics

Other donation of goods

List other donation of goods:

Education:

Tutor

List Subjects:

List Grades:

Professional Services:

Legal-attorney

Legal-paralegal

Physician/Nursing/Aids

Spiritual Counseling & Prayer

Counseling

Social Services

Child and Elder Care-Professional

Beautician/Barber

Other Professional Services

List profession or service:

Other Services:

Transportation-Driving

Transportation- Automobiles

Food Service/Cook

Housekeeping

Interpreter

I can speak the following language(s):

Other Services

List of other services:

Additional Comments: