TEMPORARY HOUSING ASSISTANCE PROGRAM (THAP) REQUEST FORM

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TEMPORARY HOUSING ASSISTANCE PROGRAM (THAP) REQUEST FORM

*PLEASE NOTE THAT ASSISTANCE REQUIRES PROOF OF FLOOD RELATED LOSS.
*IF YOU COMPLETE THIS FORM ONLINE, THERE IS NO NEED TO VISIT THE WCCS OFFICE UNTIL YOU ARE CONTACTED FOR AN APPOINTMENT BY A STAFF MEMBER.

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* Indicates required question

Today's Date *

MM

/

DD

/

YYYY

Name (First and Last) *

Your answer

Phone Number

Your answer

Email Address

Your answer

Physical Address of Affected Housing *

Your answer

PO Box?

Your answer

Number of people in your household? *

Your answer

Ages?

Your answer

Was your housing affected by recent flooding? *

Yes

No

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