Connect with Refuge
Share what you’re facing and how you’d like us to reach you, and our team will follow up to discuss possible support.
First Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City & State
*
Preferred method of contact
*
Call
Text
Email
What brings you to Refuge today?
*
I or my family need immediate assistance
I'm reaching out on behalf of someone else
I want to help someone in need
I want to volunteer
My church or organization wants to partner
I want to donate or provide resources
I want to learn more about Refuge
What type of immediate need are you facing?
*
Food
Housing or temporary lodging
Transportation
Utilities
Essential household needs
Clothing
Emergency travel
Other
Please briefly tell us what's happening and how Refuge may be able to help.
*
How soon is assistance needed?
*
Today
Within 24–48 hours
Within the next few days
Within the next week
I'm not sure
Is there anything else you'd like our Refuge team to know before we contact you?
Important:
Submitting this form does not guarantee financial or other assistance. All requests are reviewed based on circumstances, available resources, and Refuge's scope. Refuge is not an emergency response service; if you are experiencing a medical or safety emergency, please contact appropriate emergency services.
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