[CCIH-Haiti] Fuel Relief Fund Survey

[Sharon Franzén]

Fuel Relief Fund (the people who gave free fuel for NGO generators for 2
months after the earthquake) is trying to determine the level of need for
fuel in Haiti for recovery.  They are requesting that those working in Haiti
complete a survey to assist in this process. Please find the survey, which
is pasted below and is also attached. 

 

The completed form should be sent to krenn at fuelrelieffund.org. 

 

With thanks, 

Sharon 

 

Fuel Relief Fund Survey

Please rank the importance of fuel in relationship to your other current
needs (i.e. 1,2,3 – ‘1’ being the highest need or priority).

 

Form must be fill out completely and emailed back to
krenn at fuelrelieffund.org.

 

______ Food

______ Fuel (to run generators)

 

 Please also rate the following regarding fuel (a separate 1,2,or 3):

_____   Need for fuel

_____   Access to fuel

_____   Need for clean fuel

 

_____   Generators

_____   Water

_____   Sewage

_____   Shelter

_____   Medical

_____   Other   _______________________________________

 

Your NGO’s area of focus (i.e. Medical, Shelter, Distribution of Supplies,
Orphanage, Camp, Other ):
___________________________________________________________

Name of Organization: _____________________________________________________

Contact Name/Email: ______________________________________________________

City or Town in Haiti: __________________________   Department:
_______________

Other Comments: _________________________________________________________
____________________________________________________________________________
____________________________________________________________________

 

Form must be filled out completely and email back to
krenn at fuelrelieffund.org 

 

Fuel Relief Fund website: www.fuelrelieffund.org

 

 

 

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