Get Help - The Greater Pine Island Alliance

Get HelpNadine Slimak2024-10-13T14:16:12-04:00

Need Help?

If you need help recovering from the impacts of Hurricane Ian or the more recent Hurricanes Helene and Milton, please fill out and submit this form. We will review the information you provide and get in touch. (Please note: we are experiencing an issue with the photo upload for some mobile users. If you are submitting this form using your smart phone, please do not add an image at this time.)

First Name *

Last Name *

Phone number *

Can you receive text messages at this number? *

Yes

Email address *

Date of Birth

Street Address *

City *

State *

Is this your primary residence? *

Yes

Do you own or rent your home? *

Own

Rent

Where are you currently living? *

I am able to live in my home

I have a temporary rental

I am staying with family or friends

I am living in an RV

I am staying in a hotel/motel

I am living in a tent

I am living in my vehicle

Are you already working with a disaster case manager (DCM)? *

Yes

If you are working with a DCM, which agency are you working with?

UMCOR

FEMA

Unite Florida

Other

How many people live in your household? *

Is anyone in the household a veteran? *

Yes

Does anyone in the household have disabilities or special needs? *

Yes

If we could help you secure safe, affordable housing off island, would you consider relocating? *

Yes

Any additional comments that you would like to add?

Upload a photo showing the damage/repair needed. (This is NOT required.) Please note, mobile users are having issues submitting images. If you are filling out this form using a smartphone, please do not upload an image at this time.

Choose File

Dedicated to the long-term recovery of Greater Pine Island

GPIA IS A 501(C)3 ORGANIZATION — FEDERAL TAX ID #92-1305064. A COPY OF THE OFFICIAL REGISTRATION (#CH71364) AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE FLORIDA DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-435-7352 WITHIN THE STATE OR AT WWW.FDACS.GOV/CONSUMER-RESOURCES/CHARITIES. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.

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