My business has been impacted by the Camp Fire and I need help!
If you are an individual or business needing help re-establishing your office space please fill out this form so we can help direct support your way.
Email address *
First and Last Name *
Business Name
Type of Assistance
Hours needing access
Clear selection
How many workstations or employees needing space?
How long do you need space for?
What do you specifically need help replacing regarding your office? This list will help us direct donations to purchases.
Chicostart Privacy Policy Statement *
Chicostart Privacy Policy: We collect information from you when you register on our site, fill out a membership form, subscribe to a newsletter or fill out a form. When doing so, as appropriate, you may be asked to enter your name, email address or phone number among other information. We use this information to personalize your experience, improve customer service, process transactions or to send periodic communications. We do not sell, trade, or otherwise transfer to outside parties your information, whether public or private. Sensitive information such as your company name, contact information, phone number and email address will be kept private. This does not include when we believe release is appropriate to comply with the law, or to protect property, safety or rights. By using our site, signing up for a membership, filling out a form,subscribing to any communications, etc., you consent to our membership and online privacy policy herein. If we change our privacy policy, we will post those changes online.
Any other comments?
Submit
Never submit passwords through Google Forms.
This form was created inside of Chicostart. Report Abuse