SnowSafe Neighbors Program - Recipient Application Name(Required) First Last Name of person filling out application if submitting on behalf of recipientAddress(Required) Street Address Zip Code Email(Required) Email of person if submitting on behalf of recipientPhone(Required)Phone number of person if submitting on behalf of recipientEligibility: To be eligible to receive snow removal assistance, the individual must meet the following (please mark all that apply):(Required) be a resident of the City of Happy Valley be over 60 years of age OR a person who is physically challenged have limited financial resources be unable to shovel his or her sidewalk and have no other resources to remove it (i.e. neighbors, friends or a hired service) Birth Date(Required) MM slash DD slash YYYY Is your home on a corner lot?(Required) Yes No Please read all the information below. Choose yes or no to each statement indicating whether or not you understand the program guidelines and your responsibilities.I understand the SnowSafe Neighbors Program are volunteers who have been asked to clear at minimum the public sidewalk associated with my property, and they may be able to shovel my driveway and a path to my front door). SnowSafe Neighbors volunteers are not required to shovel decks, backyard sidewalks, or any other area beyond the areas stated above.(Required) Yes No I understand this is a volunteer program. Applying does not guarantee I will be matched with a SnowSafe Neighbor Program volunteer. I understand applications are processed on a first-come, first-served basis.(Required) Yes No I understand my SnowSafe Neighbor volunteer will be given my name and phone number so they can contact me about shoveling my sidewalk or to notify me when they are unable to clear my snow.(Required) Yes No I understand if someone else has cleared my sidewalk, I will call my SnowSafe Neighbor volunteer as soon as possible so they do not make an unnecessary trip to my house.(Required) Yes No I understand if the snow will likely melt in 24 hours, the SnowSafe Neighborhood volunteer will likely not come to my house.(Required) Yes No I understand a City of Happy Valley employee will contact me when they have matched me with a SnowSafe Neighbor volunteer.(Required) Yes No I understand this is an annual program. I will need to complete an application each year that I am seeking assistance.(Required) Yes No I understand I will notify the City of Happy Valley at 503-783-3800 if I no longer require assistance.(Required) Yes No Please sign if you agree with the following: I qualify for this program and agree to all the conditions stated.(Required)