Thank you for pledging to purchase some of the equipment that is critical to our relief operations.

We ask that you fill out this form to let us know which item(s) you plan to purchase.

After you fill out this form, we will email you a confirmation with shipping details.

The email will contain the links to our preferred vendor for the items.  You are not required to use that vendor, however.

Again, thank you for your generosity in helping us help those affected by natural disasters.

  • Please indicate which item(s) you intend to buy and how many. You may add more to your pledge by clicking on the + sign at end of each line.
    EquipmentQty 
  • Please include here any notes or comments we should know about this.
  • This field is for validation purposes and should be left unchanged.