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UPDATED Hurricane Assistance Form
Please verify reCaptcha before submitting the form.
*
First Name
*
Last Name
Email
Phone
Immediate Needs
If you have confidential needs, please feel free to contact Rabbi Simon directly at
jsimon@zedek.org
.
*
Have you been displaced by Hurricane Helene or Hurricane Milton?
Please Select One
Yes
No
Please describe any urgent needs you currently have.
Offering Assistance
*
Are you able to offer assistance to others in need?
Please Select One
Yes
No
If yes, please indicate how you can assist:
Additional Info
Additional Comments or Information
Is there anything else you would like the Caring Community to know?
Wed, January 22 2025 22 Tevet 5785