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Central Emergency Relief Organization, BNB Building, Cr James & Coleridge Street, Bridgetown, Barbados
Copyright © 2004 CERO. All rights reserved.
*Incident:
*Date:
*Name of Affected Person:
*Age:
*National ID Number:
*Address:
Address Line 2:
Telephone Numbers:  *Home/Work/Cell (h) (w) (c)
*E-mail Address:
*Constituency:
   
*Problem:
*Assistance Required:
*Name of Person Making Report:
Contact Numbers: *Home/*Work/Cell (h) (w) (c)
The House is:
Is the Property Insured? Yes No
*Number of Occupants in the Household: Adults: Children:
Is Alternative Accomodation needed? Yes No
Is Alternative Accomodation available? Yes No
  
Sign-Up Form
Fill out our form and you will be contacted with further information.