SMM Disaster Preparedness Assistance Request
This form is being used by SendMeMissions, Inc. [a 501(c)3 non-profit faith-based organization] to help assist Hardee County Families that are in need of disaster preparedness help before hurricane season or a specific storm. Priority is given to individuals with disabilities, elderly, single parents with infants or special needs children. Please make sure that you have been given permission to submit someone else's information and they are aware that we will be contacting them. This form does NOT guarantee assistance, but instead helps us make contact with individuals to assess the situation.
Have you submitted a Disaster Preparedness Request to any other state, private, church or volunteer agency? (If yes, click other and list who you submitted with already)
Who is submitting request...
Home Owner (which is myself)
Home Owner/Landlord (I rent or lease this property)
Renter (which is myself)
Friend or Relative (I'm requesting assistance on behalf of someone)
SendMeMissions (Volunteer Command Center)
Agency/Organization/Business (I'm requesting assistance on behalf of someone)
Government Agency (We've been notified of a need and requesting assistance on behalf of them)
Church (We are requesting assistance on behalf of someone)
Choices Family Resource Center (Community Agency)
Cutting Edge Ministries (Community Agency)
Hardee Help Center (Community Ageny)
NuHope Elder Care Services (Community Agency)
If filling this form out on behalf of someone else, please list your Agency Name, Contact Person & Number. (i.e. Hardee Help Center, John Doe, 863-773-0000)
Name of person needing assistance
House Number and Street Name
Phone Number # (with area code)
Other information that will help us locate the address.
Do you have a church home? If yes, please list here:
Eligibility for Special Considerations (mobility, age)
Medical Limitations (i.e. recent surgery)
Single Parent (with infant or young children)
Single Parent (with special needs child)
What type of preparedness assistance do you need help with?
Generator Start Up (labor only - must have your own generator & gas)
Board Up Windows (labor only - must have your own boards)
Sandbags (fill up and/or install)
Relocate Outside Furniture (patio furniture, chairs, etc)
Anything else we need to know:
This website, its services, and associated individuals or entities are not liable for damages, including loss of life, limb, or property. This website is not affiliated with any government organization. It is a volunteer-run website, and is meant and advertised as a best-effort, Good Samaritan initiative. Call 911 for emergencies.
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