Directly Impacted Supply Requests
KĀKOʻO MAUI DISTRIBUTION CENTER

Open to those directly impacted by the wildfires in need, specifically households that lost their primary residence in the Maui Wildfires. 

If you or someone you know have been impacted by the Maui Wildfires, our Kākoʻo Distribution Team is here to assist you. We have a limited selection of long term supplies. Please be advised we cannot guarantee fulfillment of all requests.


Pick up is by appointment only.  

In Google anmelden, um den Fortschritt zu speichern. Weitere Informationen
Is this application for yourself or for someone else? *
Name of Applicant *
If different than impacted, please also include impacted name
Phone Number *
Email *
Impacted Address *
Current Address
Household Size *
Do you work with any of these organizations/programs? *
Check all that apply
Pflichtfrage
Impact Verification *
Enter FEMA, American Red Cross, and/or other organization registration number
What program or assistance have you received to help with your intermediate housing solutions?
*
Select all that apply
Pflichtfrage
Are you in need of short-term or long-term supplies? *
Which short-term supplies are you in need of, if any? *
Please only select short-term items here. Long-term requests will follow.  Please be advised we cannot guarantee fulfillment of all requests.
Pflichtfrage
Which long-term are you in need of, if any? *
Please select all that apply. Specifics will be communicated during intake. Please be advised we cannot guarantee fulfillment of all requests.
Pflichtfrage
Senden
Alle Eingaben löschen
Geben Sie niemals Passwörter über Google Formulare weiter.
Dieser Inhalt wurde nicht von Google erstellt und wird von Google auch nicht unterstützt. Missbrauch melden - Nutzungsbedingungen - Datenschutzerklärung