Emergency Relief for Fire Evacuees

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* 1. Name of Organization

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* 2. Address

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* 3. Contact Person

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* 4. Email Contact

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* 5. Phone Contact

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* 6. Can contact information be made public?

Yes

No

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* 7. How much outside space can you provide? (give any special instructions)

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* 8. Will restrooms be available?

Yes

No

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* 9. How much inside space is available? (put none if inside not available)

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* 10. Is there water access?

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* 11. Would pets be allowed on the property?

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* 12. Will there be supervision present on the property?

Yes

No

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* 13. Anything else about your site we should know?