The form below is for residents of Long Beach, NY.
For assistance outside of Long Beach please CLICK HERE
There are two ways to request assistance.
1- You contact us by using the easy email form on this page.
2- CLICK HERE to print out a Request Assistance Form to mail.
Our Program Coordinator will contact you to discuss what needs to be done.
Any further questions, please leave a message with you name and number:516-256-4567
We will get back to you. Thank you.