Direct Support
Sometimes people impacted by disasters need help with large expenses, such as paying medical bills or funeral expenses, finding a new home, keeping up with rent or utilities, or similarly difficult circumstances, and could benefit from a more personal connection. Are you down to pledge a certain amount of money for direct support, and be connected directly with an impacted individual or family to be a lifeline for them in a time of crisis? If yes, thank you so much. Please fill out the information below, and Mutual Aid Disaster Relief coordinators will connect you to people who have reached out for this kind of support.
Sign in to Google to save your progress. Learn more
What is your name?
What is your phone number?
What is your email address?
What city, state, or region do you live in?
How much are you able to pledge for direct support to disaster-impacted people?
Do you want to pledge on a onetime or ongoing basis?
Are you able to offer anything else in addition to financial support (such as a spare room or emotional support)?
Are there any specific situations you are especially drawn to support with?
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy