Diocese of Imus Social Action Commission
Receiving of Relief Goods
Preliminary Data
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Address
*
Main Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Inventory of Goods
Water
Rice
Canned Goods
Sanitary Napkins
Toiletries
Used Clothing
Noodles
Bread
Powdered Drink
Diapers
Pillows
Blankets
Banig
Towels
Medicines
Biscuits
Candies
Others
Received by
First Name
Last Name
Record
Should be Empty: