Pembroke Hope Application

If you need assistance, and wish to apply to the Pembroke Hope Fund, please submit the attached appilcation.

In order to be considered for assistance by PEMA for the Pembroke Hope Assistance program, this form must be completed in its entirety. Financial assistance will be reviewed for bills incurred after March 13th, 2020.   All information and decisions will be kept confidential.

PDF icon pembroke_hope_form_online.pdf85.46 KB