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Please complete the form below to connect with Myrna Guiterrez, one of United Way of the Piedmont's Community Resource Coordinators (CRC).

As a CRC, Myrna provides support to families as they work toward self-sufficiency. Some issues she may be able to assist with include: referrals, budgeting and money management, housing, education, transportation, employment, and tax preparation.

After you submit the form, you should hear from Myrna within 3 business days.

Please note : United Way CRCs do NOT provide emergency assistance. If you are seeking urgent financial assistance for rent, utilities, etc. we encourage you to reach out to 2-1-1 to see what services might be available in our community to help.

CONNECT WITH MYRNA

Name:

Phone Number:

Email Address:

Date of Birth:

Address:

City

Zip Code

Gender

Number of People in Household (including yourself):

Workplace (type N/A if this does not apply to you):

Full-Time or Part-Time

Full-Time

Part-Time

Other

School Attended by Children in Household (type N/A if this does not apply to you):

Best Time to Contact You:

How did you hear about Myrna?

Please share more about your current situation and needs. Please note: United Way CRCs do NOT provide emergency assistance. If you are seeking urgent financial assistance for rent, utilities, etc., we encourage you to reach out to 2-1-1 to see what services might be available in our community to help.

The Piedmont area assistance network, hereinafter referred to as "Charity Tracker", is a shared computerized record keeping system that captures information about people experiencing need for emergency services. I understand that all information gathered about me is personal and private and that I do not have to participate in charity tracker. I have had an opportunity to ask questions and to review the basic identity information, which is authorized by the release for the services provided to me by charity tracker participating agencies to share. I understand that information about non-confidential services provided to me by participating agencies may be shared with other participating agencies. This release of information will be effective for 3 years from today unless I make a formal request to the agency to no longer participate in charity tracker. All information is kept confidential within the United Way system.

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