211 Emergency/Domestic Abuse Request

After a domestic abuse incident, house fire, or natural disaster, Project Just Because helps families get back on their feet by providing basic necessities. This may include toiletries, clothes, other supplies, and access to our furniture network. We keep very special comfort items just for kids when they come out of their home and go into a safe house.

As always, this program is confidential and private.

If you need help recovering from a domestic abuse situation or other household emergency, please complete the form below. We can only provide you with items you have requested if we have them in stock.

Shelter/Safe House

If you currently live in a shelter or safe house, please list the name and contact info for the shelter/safe house.

Additional Information

Adult #1

Women: please use a number size when possible. For example: “women’s 10”
Men: please specify waist x length for pants. For example: “men’s pants 36×30”

Adult #2

Women: please use a number size when possible. For example: “women’s 10”
Men: please specify waist x length for pants. For example: “men’s pants 36×30”

Adult #3

Women: please use a number size when possible. For example: “women’s 10”
Men: please specify waist x length for pants. For example: “men’s pants 36×30”

Adult #4

Women: please use a number size when possible. For example: “women’s 10”
Men: please specify waist x length for pants. For example: “men’s pants 36×30”

Child #1

Please specify exact sizes. For example: child shirt size 8, child pant size 10.

Child #2

Please specify exact sizes. For example: child shirt size 8, child pant size 10.

Child #3

Please specify exact sizes. For example: child shirt size 8, child pant size 10.

Child #4

Please specify exact sizes. For example: child shirt size 8, child pant size 10.

Child #5

Please specify exact sizes. For example: child shirt size 8, child pant size 10.

Child #6

Please specify exact sizes. For example: child shirt size 8, child pant size 10.

Demographic Information (optional)

This information is used for funding purposes only! Your answers will not impact the fulling of your order in any way (even if you choose not to complete it). The information gathered may help Project Just Because to receive grants to further benefit those in need. Thank you!
(Please select all that apply)
If you selected "other", please describe how you identify your ethnicity.

Submit

For security verification, please enter any random two digit number. For example: 17