<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:x="urn:schemas-microsoft-com:office:excel" xmlns:m="http://schemas.microsoft.com/office/2004/12/omml" xmlns="http://www.w3.org/TR/REC-html40"
xmlns:ns0="urn:schemas-microsoft-com:office:smarttags">
<head>
<meta http-equiv=Content-Type content="text/html; charset=iso-8859-1">
<meta name=Generator content="Microsoft Word 12 (filtered medium)">
<style>
<!--
/* Font Definitions */
@font-face
{font-family:"Cambria Math";
panose-1:2 4 5 3 5 4 6 3 2 4;}
@font-face
{font-family:Calibri;
panose-1:2 15 5 2 2 2 4 3 2 4;}
@font-face
{font-family:Tahoma;
panose-1:2 11 6 4 3 5 4 4 2 4;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{margin:0in;
margin-bottom:.0001pt;
font-size:11.0pt;
font-family:"Calibri","sans-serif";}
a:link, span.MsoHyperlink
{mso-style-priority:99;
color:blue;
text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
{mso-style-priority:99;
color:purple;
text-decoration:underline;}
p.MsoAcetate, li.MsoAcetate, div.MsoAcetate
{mso-style-priority:99;
mso-style-link:"Balloon Text Char";
margin:0in;
margin-bottom:.0001pt;
font-size:8.0pt;
font-family:"Tahoma","sans-serif";}
span.EmailStyle17
{mso-style-type:personal-compose;
font-family:"Calibri","sans-serif";
color:windowtext;}
span.BalloonTextChar
{mso-style-name:"Balloon Text Char";
mso-style-priority:99;
mso-style-link:"Balloon Text";
font-family:"Tahoma","sans-serif";}
.MsoChpDefault
{mso-style-type:export-only;}
@page WordSection1
{size:8.5in 11.0in;
margin:1.0in 1.0in 1.0in 1.0in;}
div.WordSection1
{page:WordSection1;}
-->
</style>
<!--[if gte mso 9]><xml>
<o:shapedefaults v:ext="edit" spidmax="1026" />
</xml><![endif]--><!--[if gte mso 9]><xml>
<o:shapelayout v:ext="edit">
<o:idmap v:ext="edit" data="1" />
</o:shapelayout></xml><![endif]-->
</head>
<body lang=EN-US link=blue vlink=purple>
<div class=WordSection1>
<p class=MsoNormal>Fuel Relief Fund (the people who gave free fuel for NGO
generators for 2 months after the earthquake) is trying to determine the level
of need for fuel in Haiti for recovery. They are requesting that those working
in Haiti complete a survey to assist in this process. Please find the survey,
which is pasted below and is also attached. <o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>The completed form should be sent to <a
href="mailto:krenn@fuelrelieffund.org">krenn@fuelrelieffund.org</a>. <o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>With thanks, <o:p></o:p></p>
<p class=MsoNormal>Sharon <o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal align=center style='text-align:center'><b><span
style='font-size:14.0pt'>Fuel Relief Fund Survey<o:p></o:p></span></b></p>
<p class=MsoNormal>Please rank the importance of fuel in relationship to your
other current needs (i.e. 1,2,3 – ‘1’ being the highest need
or priority).<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>Form must be fill out completely and emailed back to <a
href="mailto:krenn@fuelrelieffund.org">krenn@fuelrelieffund.org</a>.<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>______ Food<o:p></o:p></p>
<p class=MsoNormal>______ Fuel (to run generators)<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal style='text-indent:.5in'> Please also rate the following
regarding fuel (a separate 1,2,or 3):<o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'>_____ Need for fuel<o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'>_____ Access to fuel<o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'>_____ Need for clean fuel<o:p></o:p></p>
<p class=MsoNormal style='text-indent:.5in'><o:p> </o:p></p>
<p class=MsoNormal>_____ Generators<o:p></o:p></p>
<p class=MsoNormal>_____ Water<o:p></o:p></p>
<p class=MsoNormal>_____ Sewage<o:p></o:p></p>
<p class=MsoNormal>_____ Shelter<o:p></o:p></p>
<p class=MsoNormal>_____ Medical<o:p></o:p></p>
<p class=MsoNormal>_____ Other _______________________________________<o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>Your NGO’s area of focus (i.e. Medical, Shelter,
Distribution of Supplies, Orphanage, Camp, Other ):
___________________________________________________________<o:p></o:p></p>
<p class=MsoNormal>Name of Organization: _____________________________________________________<o:p></o:p></p>
<p class=MsoNormal>Contact Name/Email:
______________________________________________________<o:p></o:p></p>
<p class=MsoNormal>City or Town in Haiti: __________________________
Department: _______________<o:p></o:p></p>
<p class=MsoNormal>Other Comments:
_________________________________________________________
________________________________________________________________________________________________________________________________________________<o:p></o:p></p>
<p class=MsoNormal> <o:p></o:p></p>
<p class=MsoNormal>Form must be filled out completely and email back to <a
href="mailto:krenn@fuelrelieffund.org">krenn@fuelrelieffund.org</a> <o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal>Fuel Relief Fund website: <a
href="http://www.fuelrelieffund.org">www.fuelrelieffund.org</a><o:p></o:p></p>
<p class=MsoNormal><o:p> </o:p></p>
<p class=MsoNormal><b><span style='font-size:12.0pt;color:#943634'><o:p> </o:p></span></b></p>
<p class=MsoNormal><o:p> </o:p></p>
</div>
</body>
</html>