Lahaina Resource and Recovery Center (LRRC)
HOME FURNISHINGS APPLICATION

LRRC serves persons displaced by the Lahaina and Kula fires. Please fill out this form to register to receive services from LRRC which include Furnishings, some Daily Essentials and Non-Perishable Foods. We do not offer financial services or housing. One registration per household. Please register only once. If you have already registered and received services, just contact us by email or phone to schedule a return visit.
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DISPLACED FROM *
Applicant / household was wildfire displaced from where on Maui
Seeking Services *
Which services are you seeking?  We do not offer financial services or housing.
Required
Affected employment
Was your employment affected by the 2025 Federal budget cuts?
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APPLICANT NAME
 *
Name of person applying for service (enter First and Last Name)
APPLICANT PERSON GENDER *
APPLICANT PERSON ETHNICITY *
APPLICANT PERSON - PART HAWAIIAN? *
We gather this only because of possible funding resources that support specific ethnic demographics.
CONTACT INFO
PHONE *
EMAIL
SECONDARY PERSON NAME
Second person in household who might receive services from this application
MEMBERS OF HOUSEHOLD
Number of displaced persons in household
TOTAL MALE ADULTS (18 and over) *
Total number MALE adults in household (18+ years)
TOTAL FEMALE ADULTS (18 and over) *
Total number FEMALE adults in household (18+ years)
TOTAL MALE CHILDREN (0-17) *
Total number MALE children in household (0-17 years)
TOTAL FEMALE CHILDREN (0-17) *
Total number FEMALE children in household (0-17 years)
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