Hurricane Helene Aid | Emerge4Unity

County of Residence

First name

Last name

Are you a US citizen

Yes

No

Email

Cell Phone

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Alternate Phone Number

Address (you are currently staying at)

City

State

Zip

Is the house here a mobile home?

Yes

No

Is the address you are currently staying at the one in need of repair/rebuild?

Yes

No

Number of adults in home

Number of children in home

Do you own the home or are you renting?

Home

Renter

Do you own the land or are you renting?

Land Owner

Renter

Select any of the following that you DO NOT HAVE.

Power

Water

Septic

Service needed (select all that apply)

Home Repair

Muck Out

New Home

Business Related

FEMA Application Approved or Denied?

Approved

Denied

Are you receiving other assistance?

Yes

No

Are you currently in mitigation?

Yes

No

FILE UPLOADER INSTRUCTIONS PLEASE READ!

Below are file up-loaders. You can attach only documents or pictures to them. To continue processing your application we will need you to upload at least 3 files which are:

A government issued photo ID matching your information
The FEMA letter you have received

*You may only upload one file each to the buttons below*

1. Upload your government issued photo id here:

2. Upload a screen shot of your FEMA summary located in your online FEMA portal here:

In 500 words or less please tell us your story and how the storm has impacted you and your family.

Who filled out this form?

To start the eligibility process for assistance fill out the form below