Name *

First Name

Last Name

Now that the storm has passed, how are you and your family? *

Fine, at home, no damage or injuries.

Fine, evacuated but no damage or injuries.

Home damaged but we are still in it.

Home damaged and we are displaced.

Someone's hurt, please call.

It's too early to tell.

How are your church staff and membership? *

We are not aware of any losses.

We know of some staff or members with minimal to moderate loss.

We know of staff or members with significant loss or injuries.

Are you aware of damage to your church facilities? *

We have no or minimal damage.

We have had minor damage but facility is usable.

We have had significant damage that will impede worship and ministries.

We have had major damage and will be displaced during restoration.

Can you tell us about damage in your community? *

Our area appears to have no damage at all.

Homes in our area have received minimal to moderate damage.

Homes in our area have suffered major damage.

I have not had the opportunity to survey our community nor speak to one who has.

Does your family or that of your staff need assistance? *

Yes

No

Too early to tell

Is your church in a position to help others? *

We are already at work assisting our neighbors.

We are available to assist others with manpower and resources, but need assignments.

We are currently unavailable to assist others.

Is your church in a position to host Disaster Relief teams and equipment? *

We are available to host SBC Disaster Relief teams, including overnight lodging.

We are available to host SBC Disaster Relief teams during the day, but not overnight.

We have commitments for other disaster response entities to use our facilities.

We cannot host disaster response teams at this time.