Family Registration E-mail Address Password* Confirm Password*First Name Last Name BiographyPrivate InformationPhone Number Alternate LocationAddress or location where items can be delivered or picked up? Such as trusted friend nearby. Names and ages of everyone in householdDo you have a Bank account? What is your preferred method of electronic funds transfer? NotesNotes on how to find or communicate with this family. What are their challenges? Such as mental illness. Or strengths, such as they can use the internet on their phone consistently.Internet UsageDailyA few times a weekRarelyNeverItems this Family needs.PhoneComputerSolar LightsMotor ScooterMedical ProcedureAdditional items they need Only fill in if you are not human
