Authorization and Application for
KISRA Emergency Assistance Program 

You must complete all three pages before your application can be processed. 

BACKGROUND INFORMATION

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This information will be released to the Kanawha Institute for Social Research & Action, Inc., (KISRA) staff. 

KANAWHA INSTITUTE FOR SOCIAL RESEARCH & ACTION

131 Perkins Avenue  |  Dunbar, WV 25064

Call Us: 304.768.8924  |  Fax Us: 304.768.2194  |  Email Us: KISRAinfo@kisra.org

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