Battle Realty and Company - Community Assistance Form
We know that many in our community are going through a rough time, especially with recent challenges facing government employees and changes to SNAP benefits. Battle Realty and Company wants to support you. We are currently working to raise money to provide assistance to our neighbors in need. If you and your family require assistance, please fill out the form below. Once you submit your information, someone from Grace Klein will reach out to you directly to discuss how we can help. Your information will be kept confidential.
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Please tell us about your situation. Please select all that apply.
*
I am a government employee.
I (or my household) have recently lost SNAP benefits.
Other
If you selected "Other," please briefly explain.
Please briefly describe your most urgent needs (e.g., food, utilities, etc.) This helps us understand how to best direct support.
Acknowledgement
I understand that I am requesting assistance and that my information will be shared confidentially with Battle Realty and Company and Grace Klein. I expect to be contacted by someone from Grace Klein.
Submit
Should be Empty: