Customer Feedback Form

This form is only for current residents and customers receiving services from EBALDC. Prospects interested in applying for housing should visit http://ebaldc.org/how-to-apply/ or call the Main Office at (510) 287-5353 for more details.

Customer Info

Do you live at an EBALDC Property?

YesNo

EBALDC Property

Building/Street Address

Unit Number

Unit Number (LCC)

First Name

Please enter your full name to ensure we have enough information to follow-up.

Last Name

Preferred Contact Method

Email Address

Phone Number

Address

City

State

Postal Code

Feedback Details

Does this feedback involve any of the following EBALDC services/programs?

Property Management Issue

Which EBALDC Property is this issue related to?

Priority

What would you like us to know?

Attachment

Include original completed paper form if available.

Contact Information