SBP: Client Interest Form

SBP is a national disaster recovery and resilience organization dedicated to shrinking the time between disaster and recovery. For those impacted by a natural disaster, SBP provides home rebuilding assistance in select communities and one-on-one support applying for and appealing to FEMA. We also offer preparedness and digital recovery resources for survivors navigating the post-disaster recovery process, including working with a contractor, avoiding contractor fraud, how to navigate the insurance claim process, and much much more.

Please submit the form below to inquire about our services, and a representative from our team will be in touch with you within the next five business days. Please note that submitting this form does not mean that your request for service is guaranteed.

Form Maintenance Notes

The Disaster selection governs both the SBP Site and the Queue (for Tasks) field. These are set in javascript, which can be found in the Properties section of the form. The existing structure can be mimicked to add additional options as future disasters are added.

First Name

Last Name

Mobile Phone

Email Address

How did you hear about SBP?

What disaster were you impacted by?

SBP Site

Queue (for Tasks)

What SBP services are you interested in?

Home repair and rebuilding assistanceFEMA application and/or appeals assistance

Did you apply for or receive home repair assistance from FEMA?

YesNo

Is the rebuild address located in Volusia County, Florida?

YesNo

Rebuild Address

Rebuild Street

Rebuild City

Rebuild State

Rebuild Zip Code

Rebuild Country

Contact Information