El Medio Firewise Home Resilience Interest Form

El Medio Firewise Home Resilience Interest Form

Share your home status and indicate interest in potential group-rate fire-resilient improvement opportunities.
Resident Information
First Name

First NameLast Name
Property Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Property Status
Is your home currently standing?
Was your home destroyed, but you are rebuilding or considering rebuilding?
Are you considering selling your property?
Standing Homes
Have you already completed any wildfire-hardening improvements to your home?
Who performed the work?
Approximately how much did the work cost?
Were you satisfied with the work?
Anything else you’d like to share about the work or contractor?
Would you be interested in potential group rates for fire-resilient vents for your standing home?
Would you be interested in potential group rates for metal gutters and gutter guards for your standing home?
Rebuilding
If you are rebuilding, do you plan to install fire-resilient vents?
If you are rebuilding, do you plan to install metal gutters and gutter guards?
Your responses will help El Medio Firewise better understand neighborhood needs and explore potential opportunities that may benefit residents. This form is for planning and interest-gathering purposes only and does not create any obligation or commitment.
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