Carteret LTRA Initial Intake Form
We are here to help for the long haul! Recovery is a marathon and while we know it is easy to get discouraged, take heart! Hope is on the way. We have over 25 cases that we are working on and through our partnerships with other groups in the county, we have over 200 cases. We believe that there are over 6000 homes in the county that will need to be repaired. We might not be able to get you back into your home today, but know that if you contact us, your request will be heard. We cannot promise to fix every house by the end of the day, week or month, but we can promise that you are not alone in this recovery process. Please contact us and let us know how we can partner with you in your rebuilding process. We are currently accepting volunteers but ask that our volunteers be patient as we are beginning to mobilize work teams. Many hands make light work, even when there is lots of work to be done. When you contact us to give or receive help, know that we are an organization run by volunteers and we will get back to you as soon as possible.

DISCLAIMER: The information provided on this form is intended only for the use of Carteret Long Term Recovery Alliance ("CLTRA") and Third Party Partners specifically designed and designated to assist clients with disaster recovery. CLTRA and it's Third Party Partners will never sell or share any information provided by clients. If you do not wish for your information to be shared with Third Party Partners, IT IS YOUR RESPONSIBILITY to inform CLTRA of this request. CLTRA is a non-governmental organization.

Name *
Your answer
Birth Month *
Birth Date *
Your answer
Birth Year *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Pre-Disaster Physical Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Which of the following areas do you need assistance with? *
Required
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