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Share Your Story - Maui Registry

Maui Registry is committed to providing a platform for individuals impacted by natural disasters in Hawaii to share their experiences. Every story matters, and every voice is important. Please take a moment to share your story with us using the form below. Thank you for contributing to our community's resilience and support.

1
Contact information

First name*

Middle name

Last name*

House/unit number*

Street name & number*

City

ZIP code

State

Phone number

Whatsapp number (optional)

Email

Primary method of communication

Phone number

Email

Whatsapp number

Password*

Confirm password*

2
Demographics

Date of birth

Gender

Race

Languages

How many people are in your household (including yourself)?

Children

Adults

3
Address during the fires

House/unit Number*

Street name & number*

City

ZIP code

State

4
How has the fire affected you?

Displacement from home (temporary or permanent)

Damage to property or possessions

Health issues (physical or mental)

Employment or income loss

Disruption to daily routines or access to essential services

Increased safety concerns in the community

Impact on children's education or activities

Loss of community resources (e.g., parks, recreational facilities)

Social isolation or loss of community connections

Challenges

5
What is the biggest need for you (or your family) right now?

Resources

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Contact

2424 Maile Way Saunders 542,
Honolulu, HI 96822
mauireg@hawaii.edu

Share Your Story - Maui Registry

1Contact information

2Demographics

3Address during the fires

4How has the fire affected you?

5What is the biggest need for you (or your family) right now?

1
Contact information

2
Demographics

3
Address during the fires

4
How has the fire affected you?

5
What is the biggest need for you (or your family) right now?