Home Repair Application


Please Note: At this time we are only able to do repairs in McCreary, Pulaski, Whitley, Knox, Laurel, Jessamine counties, KY and Scott County, TN.

If you are in need of home repair and live in the above counties please fill out the form below. You will need an email address. If you do not have one use: noemail@AdventureServe.org.

If you would like a printable version of the application please click here.


Home Repair Application

Full Name:
Address:
City:
State:
Zip:
Phone Number:
Email Address:


household information

Please list the names and ages of all persons living in your home.
Name: Age:
Name: Age:
Name: Age:
Name: Age:
Name: Age:
Name: Age:
Check all that apply to your household:
Elderly (65+) Widowed/Widower Single Parent Handicapped
What is your monthly income?
*(Optional) Where do you attend church?
Church Name
Location


regarding your home

Have we worked on your home before?
If yes, what year?
Do you own your home?
If yes, how many years
If no, who is the owner?
Owner's phone number:
My home is:
My roof is:
Do you have electrical service to houes?
What is the water supply to the house?
Can you be home the entire time the
group is working on your home?
Can you make a donation to help cover material cost?
If yes, how much?


Regarding home repairs

Please write a description of the problem for each area of your house that needs work.
Addition Needed
Exterior Painting
Interior Painting
Foundation
Insulation
Floors
Porch/Steps
Roof
Siding
Underpinning
Drywall
Property Clean-Up
Yard Work
Other
Major Renovation
Describe why you need AdventureServe's assistance with these repairs.
We MUST have specific directions to your home! Please be explicit. Start from a major road: list street
names, major intersections, major landmarks, and crossroads.
Additional Comments

A note about our process:
Applications will be accepted on an ongoing basis. Due to large quantities, we will not be able to visit all applicants. House visits will be carried out primarily in May and June.
AdventureServe is a Christian organization, but we do not ask or require our homeowners to subscribe to our beliefs. We provide home improvements for whoever may need them regardless of creed, religion, race, sex, etc.
Application does not guarantee acceptance into program. Final decisions will be made after in house visit is completed. We will attempt to visit all applicants, however, due to a large quantities we may not be able to.
Thank you for applying.

Google+