IGBO Disaster Relief – International Gay Bowling ®

IGBO^® Disaster Relief Application

IGBO^® has created a fund to provide assistance to members in a time of need. If you are one of those members, use this form to request assistance. To make certain your request is given full and appropriate consideration, please make certain to complete the form accurately and completely.

This form is to be completed by the requestor.

First Name*

Last Name*

Requester Address* (required)

The address listed below is your original address before the disaster occurred. This address must be in one of the disaster areas declared by Local, State or Federal Government and identified on the FEMA website, or comparable site for members outside the United States.

Street Address

City

Street Address

City

Country*

Temporary Address

If displaced, please enter your current address below. Do not complete this field if the Requestor Address above is accurate.

State / Province / Region

ZIP / Postal Code

Street Address

City

Country

Email*

Contact Number*

IGBO Region

IGBO Affiliation*

Request Details

Why are you seeking assistance?* (required)

Please enter a short explanation of what happened.*

Additional Notes or Comments

Affirmation of content*

Affirmation of content* (required)

I certify that the information provided on this form is accurate and complete.

Are you human?*

This field should be left blank

IGBO® Disaster Relief Application

Requester Address* (required)

Temporary Address

Request Details

IGBO^® Disaster Relief Application