Get Involved : Home Builders Foundation of Metro Devnver

Home Builders Foundation Application for Assistance

 
   
Please take your time with this form as it will be key in our ability to help you. We recommend that you write your answers in a program like Microsoft Word and paste them into the application.
Applicant (Who are the modifications for?)
Primary Contact
Applicant Home Information
Homeowner
HOA Information
Financial Information
IMPORTANT: All financial information must be provided and complete. Thank you.
Persons living in the Household
$
$
Brief Description of Circumstances
Please fill out the following section as thoroughly as possible. This information drives our application fulfillment process and is important to us. Applications that do not satisfy this requirement may be returned for resubmission or denied.
List any organizations that have denied other assistance
Description of Assistance Needed
Based on the description of circumstances listed above, describe the accessibility modifications you are seeking for your home*.
Anticipated Impact
The Home Builders Foundation’s mission is to provide opportunities for individuals and families with disabilities to achieve a better quality of life and positively enrich their communities.

Please let us know how the home modifications you listed above will impact your independence and quality of life. What do you envision or hope to be able to do, that you are not able to do today, if these modifications are completed.

IMPORTANT: Please be as specific as possible. This portion of the application is weighed in the decision to move forward in the approval process. *
Attachments
Please include any attachments that you believe help describe your circumstances or needs.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx odt ppt pptx odp xls xlsx ods.
TERMS OF ACCEPTANCE and SIGNATURE
I, the applicant for this HBF application, warrant the truthfulness of the information provided in this application.

Electronic Signature:
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
I have read the application and acknowledge that all statements given by me in this application are complete, accurate, and truthful to the best of my ability. Due to the nature of the application, I understand the Home Builders Foundation (HBF) may share basic demographic, disability, and contact information provided on the application with the HBF staff, board and committee members, volunteer crews, and any individual(s) associated with the HBF and/or a HBF project.


I understand that the HBF may perform a title search on homes considered for home modifications. I also understand that the HBF reserves the right to deny any request based on funds and resources available to the HBF, location of project, and applicability to the HBF mission.
As part of the application, approval and project process, I understand that I may be photographed or recorded. I authorize the HBF to photograph, take motion pictures, take video footage, and/or electronic sound recordings of myself and/or any extension of me (i.e. home, present family members, etc.) for the purpose of reproduction use necessary to help promote, educate, and build awareness to support the HBF mission.
Further, I agree to sign and return a Work Agreement for the scope of work to be completed at my home. I understand that if that document is not filled out in the timeframe requested by the HBF, it may delay the start of the project. If needed, I also agree to pull a permit for the work with my local jurisdiction. I agree to complete and return a Project Completion Form within two weeks of project completion. I understand that if that document is not filled out and returned, that signing this application will meet the same requirements, terms and conditions as the Project Completion Form. Finally, I acknowledge that the HBF reserves the right to terminate the contract and discontinue project work at any point during the application process and/or during the performance of the scope of work in circumstances where the HBF determines the safety and/or wellbeing of its volunteer contractors, staff and/or organization as a whole may be in jeopardy. A written notice of termination will be given by the HBF five (5) days prior to termination.
Once submitted, you will not be able to edit the form. Please review your answers before submitting.
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