Flood Mitigation Assistance (FMA) Waiting List

Please complete this form to be added to our Flood Mitigation Assistance (FMA) waiting list. When the next round of grant funding becomes available, we will contact you with information on how to apply.

Once completed, please submit this form to the Acadia Parish Office of Homeland Security & Emergency Preparedness (OHSEP) by emailing it to: Acadiaohsep@appj.org

URL

This field is for validation purposes and should be left unchanged.

Full Name(Required)

First Middle Last

Phone(Required)

Email(Required)

Physical Address (Location of Flood Damage):(Required)

Street Address Address Line 2 City State ZIP Code

Mailing Address (if different):

Street Address Address Line 2 City State ZIP Code

Names of Individuals Listed on the Property Deed:(Required)

Dates When Flooding Occurred:(Required)

Did You File an Insurance Claim?(Required)

Yes

No

Have You Ever Applied for Flood Mitigation Assistance (FMA) Grants?(Required)

Yes

No

If yes, please list the year(s):

Additional Notes (optional):

We are an Equal Opportunity/Affirmative Action Employer

All qualified persons will be considered for employment without regard to race, religion, color, national origin, sex, age, marital status, sexual orientation, ancestry, sensory, mental or physical disability, or veteran status; or any non-job related factor.

Flood Mitigation Assistance (FMA) Waiting List

We are an Equal Opportunity/Affirmative Action Employer

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