Get Assistance from The 516 Project

For a downloadable application click here…

516 Project Application 2024

Dear Homeowner: 516 Project is Building Access to Hope. We share the love of Jesus through our actions and words by helping those in need of home repairs. Our main focus is projects that impact safe access and living condition being safe and dry. Please understand that we receive many applications and can not say yes to all applicants. Applying does not guarantee work will be done.

Step 1 of 4

Which location are you applying to?
Name*
First Last
Company Name
If Applicable
Phone*
Cell Phone
Email*
Best way to contact you*
Physical Address*
Street Address Address Line 2 City State ZIP Code
Is your mailing address the same as your physical address?
Mailing Address (If Different)
Street Address Address Line 2 City State ZIP Code
Secondary Contact Name
First Last
Secondary Contact Phone
Secondary Contact Email
Are any residents currently serving or have served in the US Military?*
Number of Veterans in the household
Years of service
Are any residents disabled?*
If yes, how many disabled residents?
Please select applicants disability or special need:
Other
Race / Ethnicity*
Have you applied before?*
Have we visited your home?
Explain briefly why you are unable to complete repairs on your own?*
My main need is:*
Other

HOMEOWNER DISCLOSURE AGREEMENT
My signature indicates that all the above statements and information provided are accurate and complete.*
I agree
I certify that I do not have the financial means to hire a contractor to perform the repairs for which I am applying.*
I agree
I acknowledge and agree that I may be responsible for covering the costs of materials or fees associated with the repairs for which I am applying.*
I agree
I HAVE READ and understand the information provided by 516 Project representatives and volunteers (both skilled and unskilled). I acknowledge that most volunteers are not professionals and may not be able to complete all repairs at my home.*
I agree
I understand that I am expected to participate with volunteers at my home to the best of my ability, and the adult family members or friends on site during work days will also participate.*
I agree
I give 516 Project permission to share this document with other providers, or non-profit organizations who might be able to assist with this application.*
I agree
Applicants Signature Please type your name:*
First Last
Date*
MM slash DD slash YYYY
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An assessment team member may contact you to schedule an inspection of your home and gather additional details regarding the work requirements. You will be notified by phone or email whether or not your application has been selected. Please understand that we are primarily a volunteer-run organization and receive many applications. We kindly ask for your patience as we work to review all submissions.
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** If this form has been prepared by someone other than the homeowners, or if assistance has been given to the homeowner, please complete the following: Name of preparer
First Last
Relationship
Agency
Phone
Email
Is the homeowner aware of this application
Comments
This field is for validation purposes and should be left unchanged.