This transcription has been completed. Contact us with corrections.
For Office Use Only FRESH MEADOWS A Residential Community OWNED AND OPERATED BY NEW YORK LIFE INSURANCE COMPANY REGISTRATION FORM NAME Last First Middle Present Address How Long There? Monthly Rent Telephone Number Previous Address How Long There? Monthly Rent Do you own your Own Home? Are you or a Co-resident Member of your Immediate Family: 1. Veteran of World War II? Service Serial Number 2. Now in Service? 3. Widow of Veteran? Total Number in Family Number of Adults Number of Children Male: Female: Ages: Number of Members of Family Employed Total Family Yearly Income Name and Address of Employer of Head of Family Occupation or Title of Position Annual Salary Present Housing Conditions Please check as appropriate and fill in proper numbers. 1. Overcrowded-Yes No (a) No. of Rooms in Present Apt.: (b) No. of People in Present Apt.: 2. Doubled up with Other Family-Yes No (a) Total No. of Rooms in Hse. or Apt.: (b) Total No. of People: (c) Other Family Related to you-Yes No 3. Furnished Room 4. Hotel 5. Are there any other factors which make your Housing Need Acute? Please Mail to Fresh Meadows Rental Office, FRESH MEADOWS CLUB HOUSE, 188-10 64th AVENUE, FLUSHING, N. Y.