Survey of Individuals and Families in Need

This important survey is designed to identify the housing needs of two major population groups of the Island: Senior Citizens and Younger Individuals and Families. This fact gathering survey is a key part of an effort to find ways to fulfill the housing needs of local people. Initiated by Father Steve Crowson of St. Maryís Church, tbe study is being conducted by fellow residents and Town Board members.

If you fit in either category and need to find a better solution for your housing - please respond to the appropriate questions below and check the appropriate descriptions. This information will be important in the effort to find solutions for local citizensí housing needs.

Senior Citizen Housing

* I own my home __ Rent __ Live with family or friend. ____ Live with family or friend in a separate apartment ___Other (please describe) ______________________________________

* I want to change my housing because I: Canít afford it ____ Canít keep up with maintenance ____ Am too isolated ____ Donít want to bother with the upkeep. Other reason (please briefly explain) ____________ Handicap accessibility is a need Yes ___ No ___

* What I (we) really need is: _______________________________________________________

* Would you attend a meeting to discuss your housing needs and options? Yes No

Individual and Family Housing Needs

* There are _____ people in my familyís housing need.

* Currently we: Own ___ Rent ___ Rent but must vacate in summer ___ Times had to vacate in last five years _____ Live with parents ____ Live in a multiple family house ____ Other (please briefly describe) _________________________________ We have ____ bedrooms

* Our housing need during the next few years is: A lower rental cost ___ A year around rental (not forced out for the summer) _____ Owning our own home ____ We need ___ bedrooms Other (please briefly describe) _____________________________ Handicap accessibility is a need Yes ___ No

* Would you attend a meeting to discuss your housing needs and options? Yes __ No


To indicate your personal housing need, please print this survey,  complete your portion and leave it in the box on the table in the lobby of Town Hall or mail by May 26, 2000 to: Housing Needs, P.O.Box 3032, Shelter Island Hgts.,NY, 11965

ď Optional: If you want to be contacted regarding your housing need, please note your name, address and telephone number here: _____________________________________________________________________