Salvation Army Team Emergency Radio Network

Health and welfare Information Request Form

Please use this form to submit your inquiry. Your inquiry will be sent to the disaster area, where SATERN personnel will attempt to locate the person or persons about whom you are inquiring. Please supply as much information as possible.

Enter your personal information in this section:

First Name (Required)			Last Name (Required)
Address			City
State/Province			Zip/Postal Code
Country			Tel. Number (Required)
Email Address (Required)

Please enter the following information about the person about whom you are inquiring.
Please fill in as much information as you can. The more you tell us, the better we can
do the research.

First Name (Required)			Last Name (Required)
Address			City
State/Province			Zip/Postal Code
Country			Tel. Number
Email address			Cell Phone

Please enter anything else to aid in locating the person about whom you are inquiring.

Thank you for your inquiry.

Privacy Statement

The information submitted here will be used only for the purpose of locating and determining the health and welfare of the person or persons about whom you are inquiring and for replying to your request. We will not use this information for any other purpose.