Bainbridge Vacant Homeowners Respond Survey
If you have more than one vacant home to offer, please complete a separate survey for each home. Thank you.
1.
What is your first and last name?
2.
What is your email address?
3.
Please enter your contact phone number.
4.
Please select the type of vacant home you may be able to make available to a first responder.
Single Family Home
Accessory Dwelling Unit attached to my home
Accessory Dwelling Unit not attached to my home but on my property
Condominium or Townhome
Other (please specify)
5.
Please select how many bedrooms this home has?
0 Bedrooms (Studio)
1 Bedroom
2 Bedrooms
3 Bedrooms
4 Bedrooms
6.
How many full or 3/4 bathrooms does this home have?
One
Two
Three
Four
7.
Your completion of this survey assumes that you may be willing to provide access to this home for a 1st responder who needs to live separately from their family during this time. Please select one of the choices below regarding compensation for this home.
I am able to provide this home for free.
I would need to receive some payment to cover basic expenses like cleaning or utilities.
I would need to receive full payment to cover larger expenses such as a mortgage.