Rebuild Staten Island Foundation Mold Remediation Grant Application
The following is the application for a grant to cover the full cost of supplies for Dry Ice Blasting. Supplies include Dry Ice and Antimicrobial Disinfectant Spray for any non porous surfaces. Upon submission of the application a representative of the Rebuild Staten Island Foundation will contact you to schedule an assessment to determine if you are in need of Dry Ice Blasting. The Dry Ice blasting process is non-conductive, non-corrosive, non-toxic and 100% effective when operated by a Dry Ice Blasting Professional. If you have any further questions you can send them to RBSIFMold@gmail.com
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First Name *
Last Name *
Address *
Apt.
City *
State *
Zip Code *
Cell Phone *
Home Phone
Email Address *
Preferred method of communication *
Insurance *
Required
Previously treated for Mold *
When are you available for remediation consultation *
Select All that apply
Required
When can remediation begin? *
PROFILE CERTIFICATION AND ACKNOWLEDGEMENT
By filling this form I confirm that to the best of my knowledge the above information is true and is submitted voluntarily. I understand that any false statement, misrepresentation or omission may cause rejection of grant distribution. I understand that this grant will only cover supplies used for dry ice blasting and will not cover the cost of labor.
Date *
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Signature *
First and Last Name
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