Page 1 of 1

ReBUILD Spokane - Community & Recovery Connection Form

Habitat for Humanity-Spokane is gathering information from community members, organizations and potential partners as we learn more about the needs and resources connected to long-term wildfire recovery.

Submitting this form does not constitute an application for assistance, establish eligibility, or guarantee that Habitat for Humanity-Spokane will provide a service.

Who are you?

Were you or your Business / Organization personally affected by the recent wildfires?

Yes

Preferred method of contact

Would you like to receive updates about ReBUILD Spokane?

Required consent

I agree to receive communications from Habitat for Humanity-Spokane and understand that I can withdraw my consent to receive communications at any time.

Permission to use and share information

By submitting this form, I authorize Habitat for Humanity-Spokane to collect, use, store, and share the information I provide with appropriate third-party partners, organizations, agencies, contractors, service providers, and other entities involved in planning, coordinating, or supporting community recovery and response efforts. This may include sharing information to help evaluate needs, coordinate services or resources, identify potential assistance or partnership opportunities, and support recovery planning.

I understand that information may be shared only as appropriate for these purposes and that submitting this form does not create a service agreement or guarantee that I will receive assistance.

Required consent

I agree to the collection, use, and sharing of the information I provide as described above.