Contact us

Choose One

First name

Last name

Phone

Address

Best way to reach you in an emergency (call / text / radio / other)

What equipment do you have? *(examples: chainsaw, tractor, generator, snow plow, 4x4 vehicle, water trailer, fuel, etc.)*

Do you have a horse or livestock trailer that could be used for evacuation? *(If yes, what size / type?)*

Can you house animals in an emergency? *(If yes, what kind — horses, cows, goats, chickens, dogs, cats?)*

Do you have heavy equipment? *(skid steer, backhoe, bulldozer, dump truck, etc.)*

What skills can you offer? *(first aid, firefighting, chainsaw work, animal handling, mechanical repair, etc.)*

Anything else you're willing to share or help with?

What help might you need in an emergency? *(evacuation help, snow removal, generator power, ride to town, medication pick-up, etc.)*

Do you have medical needs we should know about? *(examples: oxygen, dialysis, mobility issues, medication that requires refrigeration, etc. — just what you're comfortable sharing)*

Do you have animals that may need evacuation help? *(if yes, what kind and how many?)*

Is there anything else we should know to keep you or your household safe?

Is it okay to contact you during an emergency? (Yes / No)