Required fields are marked with asterisks (*)

We want to hear from you!

Please complete this form to report damages you suffered.  There is no guarantee that funding will come available, but we need your reports to try and receive funding.

Please fill out one row for each crop type damaged. If more than 3 crop types were damaged, please include that information in the large text box provided below. You do not need to differentiate between different varieties of the same crop type (e.g., separate avocados and oranges on different rows, but there is no need to separate Bacon, Hass, and Fuerte avocado varieties)