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Public Information Office

Faculty & Staff Assistance Form

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Name:

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Phone:

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Email:

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Dept:

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Shelter & Resources

Resources Requested I/We are in need of: Shelter Storage Other: (Shelter) number displaced & ages: Males/ages: ex. 2 / 24, 28 Females/ages: ex. 2 / 24, 28		Resources Available to Share Accommodations (type/number): Storage: (location/size): Other:
Assistance
Assistance Requested I need help with: Moving Moving items out of wet basements Interior Cleaning Driving vehicles larger than a pick-up truck Exterior Clean-up Assisting the Red Cross with shelter duties Assisting with animal care Other: Please provide any specifics (when, where, etc.) that will help us organize the assistance:		Assistance Offered I am able to help with: Moving Moving items out of wet basements Interior Cleaning Driving vehicles larger than a pick-up truck Exterior Clean-up Assisting the Red Cross with shelter duties Assisting with animal care Other: