red arrow Location:
571 Petersburg Road
Dennisville, N.J. 08214
Phone: 609-861-9700
County of Cape May
red arrow right Email: Main Office
 Official Web Site of:
The Township of Dennis
County of Cape May
New Jersey		 red arrowHours:
Dennis Township Administrative
Offices are open daily
from 8:30 a.m. to 4:00 p.m.
Monday thru Friday
red arrow right Email: Information
  Menu
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red arrow History & Organization of the Committee
red arrow 2010 Committee Meeting Schedule
red arrow 2010 Holiday Schedule
red arrow Mayor and Committee
red arrow Administrative Officers
  Departments:
red arrow Environmental Commission
red arrow Construction Department
red arrow Planning Board & Schedule
red arrow Zoning Board of Adjustment
red arrow Emergency Management
red arrow Recreation Department
red arrow Volunteer Fire Dept.
  Public Works:
red arrow Leaf & Bulk Collection Schedules
red arrow Recycling Information
  Museum & History Center:
red arrow Old School House Museum & History Center
  Senior Citizen Center:
red arrow Senior Citizen Center
  Online Code:
red arrow Dennis Township Code
  Notices & Info:
red arrow Dennis Twp. Vision 2030
red arrow Public Notices
red arrow Phone Numbers & Email
red arrow Gypsy Moth Information
  Municipal Court Info:
red arrow Municipal Court
red arrow Traffic Ticket Info & Payment Options
  Licenses & Fees:
red arrow Licenses and Fees
  Downloads & Forms:
red arrow Dennis Township Downloads & Forms
  General Information:
red arrow Public Safety Organizations
red arrow Dennis Twp. Links
red arrow Dennisville Historic Home Owners Assoc.
red arrow Directions & Maps:
MapQuest, find and print maps to your destination in Dennis Township!
red arrow Web Site Map
U.S.A Flag animated      We shall never forget this day and those we lost on 9-11-01
   
TOWNSHIP OF DENNIS
OFFICE OF EMERGENCY MANAGEMENT
P.O. Box 204, 571 Petersburg Road
Dennisville, NJ 08214

SPECIAL NEEDS ONLINE FORM - 2010

Name of person with Special Needs:
    - Name (Required)
    - Address (Required)
    - Address
    - City (Required)
    - State (Required)
    - ZIP/Postal Code (Required)
    - Home Phone (Required)
Description of Special Needs:
    Wheelchair Bound
    Dialysis Patient
    Diabetic
    Hearing Impaired
    TTY/TDD

    Special Medications
    Oxygen
    Blind
    Uses Seeing Eye Dog
    Language Barrier
Additional Information:

Special Instructions:

Individual Completing Form:
    - Name (Required)
    - Address (Required)
    - Address
    - City (Required)
    - State (Required)
    - ZIP/Postal Code (Required)
    - Home Phone (Required)
    - Work Phone
    - Email
    - Date (Required)
        

THEINFORMATION CONTAINED ON THIS SPECIAL NEEDS FORM MAY INVOLVE PERSONAL MEDICAL INFORMATION WHICH IS NOT SUBJECT TO THE STATE RIGHT-TO-KNOW LAWS. THE INFORMATION ON THIS FORM IS CONSIDERED PERSONAL AND PRIVATE AND IS PROVIDED FOR THE SOLE PURPOSE OF DEVELOPING A SPECIAL NEEDS DATABASE TO BE UTILIZED BY THE TOWNSHIP OF DENNIS OFFICE OF EMERGENCY MANAGEMENT, AND/OR ANY OF ITS DESIGNATED AGENTS ASSOCIATED WITH THE 9-1-1 DISPATCH CENTER.
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Township of Dennis Official Web Site:
www.DennisTwp.org
2010 Township of Dennis. All rights reserved.		 Dennis Township Seal image
Web Site Designed & Maintained by:
Power Of Production Studio
Web Comments to: Thomas H. Laughlin