Victim Contact Information Form

Click Here: Victim Contact Information Form

We need your help! With organizations willing and wanting to help the tornado victims with their needs, it is imperative that we are able to contact those who are living or once lived in the tornado path. Filling out this contact form could mean the difference between a family receiving free aid and not receiving it. This form is not a promise of aid, but rather an attempt to get contact information for those who might qualify for aid.

Due to the fact that so many families have moved quickly to alternate temporary/permanent addresses, contacting them is difficult. We understand that you as their friend or relative might not know all the information below, but just providing what you do know can help us develop the contact list. We will compare this form with postal records and other community resources to determine who the residents are from the damage area and how to contact them.

This information will be treated with the utmost care and not given out to contractors or businesses, but will be treated with confidentiality from the Mayor's office and the County Emergency Management Agency.

Thank you for volunteering your time as you fill out this form in care for others!

If you have any questions or concerns please contact Mayor Joe Wellman's office at 812-254-5575 or the website administrator of this form, Christopher Wiles (Minister at Washington Church of Christ), at 812-610-2484.

Click Here: Victim Contact Information Form