Congregational Disaster Response Resource Inventory

(NOTE: This sample form is intended for congregations to forward to their judicatory representative. It is not intended to submit online.)

Definition of Disaster

Disasters may be natural or human caused. Natural disasters include hurricanes, tornadoes, floods, earthquakes, fires and explosions. Some fires and explosions may be human-made. These events or situations cause human suffering or create human needs that victims cannot alleviate without assistance. Lutheran Disaster Response becomes involved when a disaster, affecting the Lutheran community, is greater than existing local resources.

Congregation:

Address:

City: State: ZIP:

Phone: Pastor:

The congregation operates (check as many as apply)

Food pantry
Clothing bank
Toilet and paper goods pantry
Other (please specify)

The congregation has facilities that can offer (check as many as apply)

Shelter and sleeping arrangements
Meal preparation facilities
Showering facilities
Phone banks or other communication needs
Other (please specify)

The congregation has facilities that can provide (check as many as apply)

Child care
Preschool
Elder care
Handicapped Accessibility
Other (please specify)

The congregation has financial resources (check as many as apply)

Contributed by members as need arises
A fund (budget line item) designated for disaster relief
Other (please specify)

The congregation has staff who are (check as many as apply)

Trained in crisis management
Name:
Trained in crisis counseling
Name:
Fluent in a language other than English
Name: Language:
Name: Language:
Name: Language:
Proficient with sign language
Name:
Other skills (please specify and include name of person with skill)
Name: Skill(s):
Name: Skill(s):
Name: Skill(s):

Has the congregation or members of its staff actively participated in disaster relief efforts in the recent past? If so, briefly describe activities.

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