Thank you for taking a moment to fill out this survey.  Please reach out to us if you think we could of be of any assistance to you during this difficult time.

Please check the items that you do not have access to during your home isolation.  This is for a 14-day supply.
*Please note that not all items are accessible. Items will be provided based on availability.

Please fill out completely.

Submissions will be presented to our board and Finance committee for approval.  Expect a 1-2 week wait for a response.

Thank you for being part of our board!  

Thank you for your service on the United Way Board!  We appreciate your honest feedback.

Please fill out this report fully and accurately. All submissions should be received by July 15, 2022