NUCA Cares Report FORM

Are you a NUCA Member Company who has (an) employee(s) who have recently experience a significate loss during a disaster? 

Please let us know so we can help! Our NUCA of Kentucky CARES Foundation is built to help our own through these disasters.

We don't know unless you tell us! 

 

Name of Contact Reporting: *
Member Company: *
Phone Number of Reporting Contact: *
Email of Reporting Contact: *
Name Member Company Employee Affected: *
Details of Significant loss & needs. : *