What is the disaster relief assistance application form template?
After a flood, fire or storm, relief organisations and churches are suddenly handling many requests for help at once. To decide who needs what first, they need the same basic picture from every household: who lives there, where they're staying now, how badly the home is damaged, whether they're insured, what they've already applied for, and what they need most — right now.
This disaster relief application gathers that in five pages. Anyone no longer at home is asked for an address where they can be reached. Disability and medical needs, pets and urgent medication are flagged with follow-up questions. Damage and losses can be described in detail with photos, and financial assistance only asks for an amount if cash help is one of the needs.
Each application is saved as a PDF in your FileIt vault, so your team can prioritise from one list rather than piles of paper and messages.
- Best for
- Relief charities, churches, community foundations and mutual aid groups responding to disasters
- Filled in by
- An affected household, or a volunteer helping them
- Time to complete
- About 10 minutes
- Includes
- Household make-up, damage level, losses, insurance, urgent needs, medication flag and photos
Who uses a disaster relief assistance application form?
- A church distributing a relief fund after local flooding
- A community foundation taking applications for emergency grants after a wildfire
- Volunteers at an evacuation centre helping families apply on a tablet
- A charity prioritising deliveries of food, water and clean-up kits
- A mutual aid network coordinating help with partner organisations
Questions on this disaster relief assistance application form
33 questions over 5 pages · includes signature, file upload, conditional questions, multiple pages, consent checkbox.
1 About you
- Your name*
- Phone*
- What happened?* Flood · Fire or wildfire · Storm, hurricane or tornado · Earthquake · Other
- Date it happened*
- Where are you staying now?* Still in my home · With family or friends · At a shelter · In a hotel or motel · In a vehicle
- Address where we can reach you now* asked only when it applies
- Address of the affected home*
2 Household
- How many people live in your household?*
- Of those, how many are children under 18?*
- How many are 65 or over?
- Does anyone have a disability or medical need that affects what help you need?*
- Please tell us more* asked only when it applies
- Do you have pets or animals that need help?
- Which animals? asked only when it applies
- Preferred language
3 Damage & losses
- Do you own or rent the home?* Own · Rent · Other (living with family, etc.)
- How badly is the home damaged?* Minor — still liveable · Major — needs repairs before it's safe · Destroyed or uninhabitable · Don't know / can't get in yet
- What was damaged or lost?* Roof, walls or structure · Flooding inside the home · Power, water or heating · Furniture and belongings · Appliances · Food · Clothing · Vehicle · Tools or equipment for work · ID and important documents
- Describe your losses
- Rough estimate of your losses
- Are you insured?* Yes — home and contents · Contents only · No insurance · Not sure
- Have you made an insurance claim? asked only when it applies
- Have you applied for any other help? Government disaster assistance · Insurance · Another relief organisation · A church or faith group · Not yet
- Photos of the damage
4 Urgent needs
- What do you need most right now?* Somewhere to stay · Food · Drinking water · Clothing · Medication · Baby supplies · Clean-up supplies or help · Emergency repairs · Transport · Financial assistance · Replacing documents · Someone to talk to
- Has anyone run out of essential medication?*
- Which medication, and for whom?* asked only when it applies
- Financial assistance requested asked only when it applies
- Anything else we should know?
5 Declaration
- Declaration*
- Sharing information*
- Signature
The disaster relief assistance application form, page by page
1 About you
Name and phone are required, email optional. What happened and when, where the household is staying now — anyone not at home is asked for an address where they can be reached — and the address of the affected home.
2 Household
How many people, how many children and how many are 65 or over. A disability or medical need question opens a detail field on yes, with examples like oxygen or medication that needs a fridge. Pets and preferred language complete the page.
3 Damage & losses
Own or rent, how badly the home is damaged (from minor to destroyed or not yet accessible), and what was damaged or lost — structure, flooding, utilities, furniture, appliances, food, clothing, vehicle, work tools or documents. A description and rough estimate of losses, insurance status (with whether a claim has been made), other help applied for and up to 10 photos.
4 Urgent needs
What's needed most right now, from somewhere to stay to someone to talk to. A required question flags anyone who has run out of essential medication, with detail on yes. Financial assistance asks for an amount only if cash help is ticked.
5 Declaration
A placeholder for your eligibility rules, then agreement that the information is true and that assistance depends on funds, consent to share information with partner relief organisations, and an optional signature.
Make the template yours
- Add your eligibility rules and decision process to the template note
- Change the disaster types and currency to fit your region
- Add a field for your case number or the area you're covering
- Edit the urgent needs list to what you can actually provide
- Set the form to close when the relief fund closes
Tips for a better disaster relief assistance application form
- Check medication and disability flags first — they're often the most urgent
- Offer the form in the languages spoken locally, and have volunteers help people fill it in
- Don't make photos mandatory; many people can't get back into their homes
- Coordinate with other agencies using the sharing consent to avoid duplicate help
- Tell applicants honestly how long decisions will take
Every response becomes a PDF in your vault
Each application is saved as a PDF, with any photos, in the vault folder you choose, and you're notified by email. Applicants who gave an email can receive their own copy.
Filter the Responses table by damage level, urgent needs or the medication flag to prioritise, and export to CSV to plan deliveries or track assistance given.
- Start from this template. It opens in the FileIt Forms designer — change any question, add pages, set the rules for when questions appear.
- Share it. Turn on a public link, or send it to people by email, each with their own link. They don’t need a FileIt account.
- Get the answers as PDFs. Each response is saved as a PDF in the vault folder you choose, with uploaded files attached — and listed in a Responses table you can export to CSV.
Disaster relief assistance application form: frequently asked questions
Is this disaster relief application template free?
Yes. It's one of the ready-made templates in the Forms app on every FileIt account, including the free plan. Use it as it is or change any question in the designer.
Do people need a FileIt account to fill it in?
No. Anyone with the public link, or a personal invitation you send by email, can fill it in without signing up.
Can volunteers fill it in for people?
Yes. It works on a phone or tablet, so volunteers at a shelter or distribution point can complete it with the household.
What if someone can't get into their home?
The damage question includes 'Don't know / can't get in yet', and photos are optional.
How do I spot the most urgent cases?
Filter the Responses table by damage level and by the essential medication question, both of which are required.
Can we share applications with partner agencies?
The form asks applicants to consent to their information being shared with partner relief organisations. Share only what's needed.