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NR DELAWARE INITIATIVE
BECAUSE HUMANITY MATTERS
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Donation Lists
Request Assistance
Last name
*
Address
*
Email
*
Phone
*
COUNTY
*
NEW CASTLE COUNTY
KENT COUNTY
SUSSEX COUNTY
HOUSEHOLD SIZE
*
1-2
2-4
4+
Are there school-age children in the home?
*
Are there Seniors in the home (Age 60+)
*
Household Income
*
0-$12,000
$12,000-$24,000
$25,000-$35,000
$36,000-$48,000
$48,000 +
Unemployed
Race/Ethnicity
*
White
Black
Hispanic
Asian
Native American
Other
Prefer not to answer
Describe your need for essential items: DE-AID does not make food or clothing donations. We focus on basic home essentials. Please briefly describe your story and what home essentials you are in need of (ex: toilet paper, toothpaste, diapers, etc).
*
Signature:
*
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