Church Employee Emergency Assistance Information
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Email *
Name of person filling out form and your title *
Have you successfully reached all of your church employees? *
Did any of your church employees experience any property damage, loss, financial distress, or unexpected expenses as a direct result of the derecho storm and aftermath?  If yes, identify in the next several questions.  If no, choose "no" and then submit the form. *
Name of impacted church employee and description of impact
Name of additional impacted church employee and description of impact
Name of additional impacted church employee and description of impact
Name of additional impacted church employee and description of impact
Name of additional impacted church employee and description of impact
A copy of your responses will be emailed to the address you provided.
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