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Truro Emergency Rental Assistance Application

Please complete the following application. If you need assistance, please call our office at (508) 255-9667 and ask to speak with a case manager. Click here to download a printable application you can send to HPC at PO Box 828, Orleans, MA 02653.

Once your application is received, a case manager will review your information and be in touch.

Contact Information
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
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Please use your preferred, best number to call.
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Identify your language preference if different than English.
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This may include more than one group.

Landlord's Contact Information
To receive rental assistance landlord MUST participate in this program. If this is left blank the application is incomplete and will not be considered.

First Name
Last Name

Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code

Please provide your landlord's best, preferred telephone number.

Certifications
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Please print your full name.
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(mm/dd/yyyy)

Please print your name.

(mm/dd/yyyy)
Release of Information
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Application Checklist
THESE MUST BE INCLUDED WITH YOUR APPLICATION OR IT WILL BE DEEMED INCOMPLETE.