121 STILLWATER ROAD, MAHOPAC, NY 10541
1-800-759-4253 | P 914-241-1711 | F 914-241-3148 | email:
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E&I MEMBER TEMPORARY HOUSING REQUEST FORM
Our long and short-term, fully furnished, completely equipped apartments offer a high-quality, cost-effective alternative to hotels for your temporary housing needs.
Authorizing Dept & Contact:
# of Days Authorized:
Size of Apartment:
Temp Housing Start Date:
If the Temporary Housing (TH) Specialist is allowed to contact the employee, and we have your department policy on file, the Dept. contact may complete only the top section (unless the request differs from the standard policy). If the TH Specialist is NOT allowed to speak with the employee, or we do not have your department policy on file, please complete all areas of this form.
Dept contact is to complete if request differs from policy grid.
OK to Contact Employee:
Bill to Institution
Pet Deposits Paid By:
Maid Service Paid By:
Utilities Paid By:
Long Distance Paid By:
Whalen's Moving & Storage Co., LLC. will protect our customer's right to privacy and will not share any information about
you to any other organization unless required by law.
Copyright © 1998 - 2008 Whalen's Moving & Storage, LLC. All Rights Reserved.