Washington Indiana Tornado Relief
We need the help of our community.  With organizations willing and wanting to help the tornado victims with their needs, it is important that we are able to contact those who were residing in the tornado path on November 17th, 2013.  Filling out this contact form could mean the difference between a family receiving free aid and not receiving it.  This form is not a promise of aid, but rather an attempt to get contact information for those who might qualify for aid.  

Due to the fact that so many families have moved quickly to alternate temporary/permanent addresses, contacting them is difficult.  We understand that you as their friend or relative might not know all the information below, but just providing what you do know can help us develop the contact list.  We will compare this form with postal records and other community resources to determine who the residents are from the damage area and how to contact them.

This information will be treated with the utmost care and not given out to contractors or businesses, but will be treated with confidentiality from the Mayor's office and the County Emergency Management Agency.
Thank you for volunteering your time as you fill out this form in care for others!

If you have any questions or concerns please contact Mayor Joe Wellman's office at 812-254-5575 or the website administrator of this form, Christopher Wiles (Minister at Washington Church of Christ), at 812-610-2484.  
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Last Name of Family
(or the last name of the head of the household)
Number of people living in the residence on November 17th, 2013.
Names of the adults living in the residence on November 17th, 2013.
First and last names are all that is needed.  
Number, names, and/or ages of the children in the damaged home.
We have donated supplies specifically for children and may have groups wanting to primarily help children of damaged homes.
Original address of the residence in the damaged area
Even if you can just give us the street name, that would help us in identifying the victims of the damage.
New mailing address, whether temporary or permanent
(Whether the victim's family has bought a new home or moved to a short term rental while theirs is being rebuilt, please offer the new mailing address.
Contact phone number for a member of the household
(We would prefer the head of the household but could use a number for anyone in the household.
E-mail address for any members of the household.
(We would prefer the head of the household but once again we could use an email address to get in touch with the family.)
Are they on Facebook?
If we can't reach them on a phone or email we may be able to send them a FB message.
Clear selection
Are they on Twitter?
If we can't reach them on a phone or email we may be able to send them a Twitter direct message.
Clear selection
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