Hurricane Harvey- Aftermath/Relief Survey

We continue to pray for safety, security, and a speedy return to normal life. Our goal is to help our WBEs who may have been affected by this storm. Please complete the survey below so we can assess what damages you may suffered from Hurricane Harvey, and so we are able to assist you to our fullest extent.

* 1. As a result of Hurricane Harvey do you need assistance in any of the following categories? (select all that apply)

Employment ( loss of wages, loss of job)

Financial ( loss of home, business, vehicle)

Food

Housing (displacement, loss of home)

Legal

Medical ( injury, illness)

None of the above

* 2. Please provide us with your contact information.

Name

Company

Email Address

Phone Number

* 3. Has your home flooded as a result of Hurricane Harvey?

Unknown

No

Yes (please describe your loss)

* 4. Has your business flooded as a result of Hurricane Harvey?

No

Unknown

Yes (please describe your loss)

* 5. We are so glad to hear your home and/or business have not flooded. Would you like to help fellow WBEs?

Visit http://www.wbea-texas.org/event-registration#id=20298&cid=563&wid=301 to donate to relief efforts.

* 6. Would you like to be considered for donations or monetary support?

Yes

No

* 7. Is there anything the WBEA can do to assist you with recovery efforts?