Resident Needs Form


Resident Needs Form

When finished, drop form in the “Resident Needs Form” box at Boro Hall!

Name (one per residence):_________________________________________________

Phone:_________________________________________________________________

Address:_______________________________________________________________

Circle one

Do you :          RENT              OWN

Due to Hurricane Sandy I lost:               ALL OF MY HOME                   PART OF MY HOME

If you circled ‘PART OF MY HOME’ be specific:_____________________________________

____________________________________________________________________________________________________________________________________________________________

How many adults (13+) live in your home (including yourself):________________

How many children (12 and younger) live in your home:___________________

In order to make my home a safe and livable environment I need help with the following items (Items should be listed in order of necessity starting with number one. Items may include but are not limited to building material, professional help, furniture, groceries, etc)

1)

2)

3)

4)

5)

4 comments

  1. Thanks for info… looked up Robin Hood Site and its now 250K

    Hope for Highlands To provide residents in this hard-hit New Jersey shore town with appliances, beds and other essential home furnishings whose replacement is not covered by FEMA or flood insurance. $250,000
    Not quite sure why HBD is handling since has nothing to do with Business.

    Peace

    Like

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