NJDH Survey
Survey Responses
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Are you interested in living in affordable housing in New Jersey designed for those who are Deaf, Hard of Hearing, DeafBlind or Late-Deafened?
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Where do you live now?
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What is your current living arrangement?
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If an apartment became available, could you move in three (3) months?
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Please tell us the number of people in your household who are:
0
1
2
3
More than 3
Over age 55
45 - 55
21 - 44
Under 21
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Check all that apply for the people in your household:
Do you have a service animal?
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How many bedrooms do you want?
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Do you need a parking space?
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Contact Information
Name:
Street Address:
City:
State:
Zip Code:
Phone:
My phone is:
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Email:
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