Viewing page 15 of 15

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.