Emergency Disaster Relief Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.In times of crisis, community means everything. That’s why the Missouri Council of the Blind has created the Emergency Disaster Relief Fund—to be a source of hope and support when our members need it most. When natural disasters strike, we know that those who are blind or visually impaired often face additional challenges in accessing resources and recovery aid. Through this fund, we are offering gift cards to eligible individuals who have been directly impacted by a declared emergency. Each blind person or MCB member within the affected area may receive one card after completing a simple application form. It’s our way of standing together, providing practical help, and reminding one another that we are never alone in the storm. Together, we are seeing the world in a different light. Name *FirstLastAddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhoneEmail *Are you a member of MCB?YesNoWhich affiliate or Member at Large?If not, please submit documentation of proof of blindness. Fax 314-832-7796 or email aa@moblind.orgCurrent Disaster OccuranceDate of Disaster Disaster Other Date Explanation of NeedMost Urgent NeedFoodShelterClothingBlindness Equipment Lost/DamagedOther (please explain below)Other NeedSubmit