Location Check in Form

Please provide any other issues you might need and please be in touch. Our plan is to check in every few days to assess needs and get supplies where they are needed. Please stay in touch! Our team is aligned with other organizations to help you with what you need

Support or question, reach out on chat or email: help@iamopen.org

Point of Contact Name

Enter the name of the primary contact person for this coordination.

This field is required.

Phone Number

Enter the contact number, including area code.

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Email Address

Provide a valid email address for communication.

This field is required.

Address of Points of Collection

Specify the address where items will be collected.

Address Line 1

This field is required.

Address Line 2

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City

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State

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Postal Code

This field is required.

Country

Address of Distribution Site

Provide the address where the supplies will be distributed.

Address Line 1

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Address Line 2

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City

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State

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Postal Code

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Country

Are you willing to be publicly listed?

Select 'Yes' or 'No' if you want to be publicly listed.

Yes

This field is required.

Do you need Volunteers?

Select 'Yes' or 'No' if you need volunteers.

Yes

This field is required.

Current Supply/Hub Needs

List any specific needs you currently have, including greywater setups, Starlinks, potable water, etc.

This field is required.