Super Storm Sandy Emergency Assistance Application.

If you would like to download this application and fax or email it to: or (732) 222-8343 you may do so by Click Here.

Briefly Describe How You Were Affected by Sandy:

Have you applied for or received assistance from any of the following?

AUTHORIZATION I authorize Providing Hope to seek verification of any bills presented and the release of information given herein for consideration by other Sandy relief funds. I attest that all of the above information is true and correct and understand that any misrepresentation of this information may disqualify me for assistance.

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