Distribution/Collection Centers This form is for churches who will be offering kits, services, or other items to those affected by the recent hurricane. If you are interested in hosting Emergency Response Teams - please call the Disaster Response Center and share that information with them. 888-440-9167. Please complete this form to the best of your knowledge. Someone from the Disaster Response Call Center will contact you if there are any questions. Location Name*Please no acronyms. What is your location collecting?*If you are not a collection site, please put NA. Please give us as much information as you can. Examples: Flood buckets, clothing, health kits, school kits. What is your location distributing?*If you are not a distribution site, please put NA. Please give us as much information as you can. Examples: We have showers, hot meals, and toiletries for those who need them. We are open from 10 am to 9 pm each day. Can you deliver gasoline but need transportation of the gas? Can you supply flood buckets, but don't have a way to get them to the MERCI center or another facility? Flood Buckets, School Kits, anything else? What hours?*Please include the hours and days of the week you are open for collection or distribution. District*Please select your District below.-- Select Your District --Not AffiliatedOther ConferenceBeaconCapitalCorridorFairwayGatewayHarborHeritageSoundContact Name* First Last Contact Email* Enter Email Confirm Email Contact Phone*NC Conference Location*Is this center within the NC Conference?YesNoNot SureAddress of Location* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Additional informationAre there any qualifications for folks? Examples: Must show id. Must be a resident of the county. PhoneThis field is for validation purposes and should be left unchanged.