Harvey - I need help - Necesito ayuda
Kennedy Fab and NBRI (local non-profit organization) working together to help your family.

Kennedy Fab y NBRI (organizacion local sin fines de lucro) trabajando juntos para ayudar a su familia

Email address
Full Name - Nombre Completo
Your answer
Address - Direccion
Your answer
City - Ciudad
Your answer
ZIP - Area Postal
Your answer
Phone number - Numero de telefono
Your answer
How many adults and children are currently in your household? (please specify) Cuantos adultos y niños se encuentran en su casa? (sea especifico)
Your answer
Are you currently in need of shelter? Esta actualmente necesitando refugio?
How are you related to Kennedy Fab or East Montgomery County? Cómo estás relacionado con Kennedy Fab o East Montgomery County?
Provide the name of your connection or referral. (Business name, employee name, customer name, family or friend name) Provea el nombre de su connexion o referencia. (Nombre del negocio, nombre del empleado, nombre del cliente, nombre del familiar o amistad)
Your answer
Do you need immediate remediation assistance to your flooded damage home? Necesita ayuda de reparacion inmediata para su casa por daños de inundación?
In a couple of sentences, how would you best describe your situation/need? En algunas oraciones, describa de la mejor manera posible su situacion/necesidad.
Your answer
What are your most immediate needs? Cuales son sus necesidades mas inmediatas?
Required
Do you have a way to get to work? Tiene como llegar a su trabajo?
If no to above question, what is your address for carpooling/pickup? Si respondio no en la pregunta anterior, cual es la direccion donde se le pudiera recojer?
Your answer
Is there anything else we need to be aware of? Alguna otra cosa que debamos saber?
Your answer
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