Church of the Rockies Flood Relief

Church of the Rockies Flood Relief

by

Serving All of Carbon County

Flood Relief Fund Request Form

Church members and other people across the country have donated to support those who were affected by the flooding in Carbon County. All households/individuals affected by the flooding are eligible to request funding assistance. We welcome anyone who has been impacted by the flooding in the region of Carbon County, MT to request financial assistance from Church of the Rockies. Please submit this form when you determine funding is needed. We will review requests when received. Anyone with urgent financial requests that need immediate attention are encouraged to fill out this form as soon as possible. We may contact you by email or telephone within a few days of you submitting this form. You are welcome to include questions for us in the final section of this form and we will reply to you as soon as possible. We are honored to have the opportunity to serve you and all in our community. We wish you as much ease as possible during this difficult time. Church of the Rockies, Red Lodge, MT
MM slash DD slash YYYY
Name(Required)
Mailing Address(Required)
Physical Address (if different from Mailing Address)
(Some forms of financial relief may be paid directly to your creditors/vendors)

Please check any of the areas of financial support that you are requesting funding for (that have NOT been covered by insurance or were only partially covered by insurance/other funds.

Please enter total dollar amount with no further information.

* Receipts and/or copies of Bills/Estimates may be requested. *

If you have any receipts and/or bills that you would like to attach, please upload below.
Max. file size: 300 MB.
This field is for validation purposes and should be left unchanged.

Share Button

  • No Widgets

    "Secondary" needs some widgets.

    • PageLines