Lutheran Disaster Response Network of Northeastern Pennsylvania

Form to Report UPCOMING Trips to Respond to Disaster Outside Northeastern Pennsylvania
 
If you or a group from your congregation is planning to go outside of our northeastern Pennsylvania Territory to assist in disaster recovery, please share your information so we can post it on our website. Not only will this tell us who is doing what in this response, but this information can also assist those who would like to join a group or those planning to go in the future. Thanks.
For further information about volunteering or filling out this form, call Ruth or Dianne at 610.770.9205 or email them at ruth@lutherancongregationalservices.org or dianne@lutherancongregationalservices.org.
 

Name of Individual or Group
From (Congregation)
City (Congregation)
State (Congregation)
Zip (Congregation)
County (Congregation)
Church Telephone
Mission District
Contact Person
Contact Phone
Contact Address
Contact City
Contact State
Contact Zip
Contact Email
Relief Details  
Date Going
Date will return
How many people can trip accommodate
Place going
How will you get there
Where will you be stationed
What you will probably do
Other information