Please complete this form if your organization is providing FREE services to individuals impacted by Hurricane Florence. Any forms received from individuals or work-for-hire teams will be deleted. All services will be shared with our NC Voluntary Organization Active In Disaster (VOAD) community and will be available to NC 2-1-1 callers.

If you are a volunteer or a group of volunteers, visit volunteernc.org to register to help with Hurricane Florence recovery.

Agency Name: *
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Contact Name: *
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Contact Position/Title in Agency: *
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Contact Phone Number: *
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Contact Email Address: *
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Main Phone for Agency: *
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Public Phone Number (Number for people to volunteer and/or register needs): *
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Agency Website:
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Agency Hours of Operation (Days and Hours): *
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Service(s) Provided (Check ALL that apply): CLOTHING DONATIONS NOT ACCEPTED NOW *
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Location(s) of Services (Check ALL that apply): *
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