The Cut Fire Fund Intake Form-The Cut Fire Fund

The Cut Fire Fund Intake Form

Haley & Patrick Cutter, along with their two children, Colum (11) and Kinsley (9), lost their home in Hingham to a massive fire July 11, 2022. They have since started The Cut Fire Fund to to support first responders as well as families with children that have been impacted by fire. Please fill out this form to help us understand what would really help you children in this difficult time. Thank you!

First Name

Last Name

Phone Number

Current Address

Date of the Fire (Within the last 30 days)

Address of the house fire

Name & Age of each child (under 18)

Essential Items Needed

Size of Clothing and Shoes

School Supplies Needed

Sport Supplies Needed

Art Supplies Needed

Baby Essential Items

Your Children(s) favorite toys, books and characters.

Name & Phone Number of Fire Department Who Responded

To help us safetly deliver the donations in a timely manner to help you and your family, please answer the following questions.

Do you have access to transportation?

Yes

If you do have access to transportation, please choose from the following your prefer place to meet for the donations.

If you don't access to transportation, is there any local coordinator/volunteer/friends that could help pick up the donations for you at one of the listed locations above? Please provide their name and contact info.