Helene Assistance

Application (must be a Laurens County resident)

First Name

Last Name

Phone Number

Email Address

Address

County

State/Province

ZIP/Postal Code

Country

Laurens County resident

Upload Damage Photo

One file only.
200 MB limit.
Allowed types: gif jpg jpeg png.

Upload Damage Photo (2)

One file only.
200 MB limit.
Allowed types: gif jpg jpeg png.

# of people in affected home (including self)

4 or more

Other…

Ages of people in the home

Interested in helping out?