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HELP Victims of 3/13/2008 Fire in Mt. Pleasant

We are assisting with the coordination of assistance to victims of the fire that occurred in Mt. Pleasant on March 13, 2008. If you can offer a place for someone to stay, please use the form below to send this information to the Columbia Heights/Shaw Family Support Collaborative. If you cannot offer a place to stay, but would like to volunteer or donate, pleaes fill out as much of the form as you can.

FULL NAME
EMAIL ADDRESS
STREET ADDRESS
PHONE NUMBER
WHAT CAN YOU OFFER
TIME RANGE START DATE:

END DATE:
NUMBER OF PEOPLE
OPTIONS OFFERED Please check boxes as appropriate:
 CHILDREN FRIENDLY
 PET FRIENDLY
 FAMILY FRIENDLY
 MEN ONLY
 WOMEN ONLY
 WOMEN AND CHILDREN ONLY
 ADULTS ONLY
 SPANISH SPOKEN
 ONLY SPEAKS ENGLISH
MESSAGE



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