We Want To Help You
This is for residents who would like help on their property relating to Wildfire. We are a "Neighbors Helping Neighbors" group who provide our service for our elderly, disabled and low-income community members. If this applies to you or someone you know, please fill out this form.
Email *
I need help with: *
Check all that apply
In a paragraph or so, tell us about your situation: *
What is your first and last name? *
What is your Phone number? *
What is the best way to reach you? *
What is the address you would like us to visit?
Are you a renter or the property owner? *
If you are a renter, can you provide permission for this assistance from your landlord? *
We sign waivers to protect all parties which property owners also need to sign prior to service
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy