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REPAH is an all-volunteer non-profit organization with the primary mission to help low-income home owners make emergency home repairs. Funds are limited and it is frequently necessary to partner with other organizations or ask that the homeowner also contribute financially, if possible.
A coordinator will promptly contact you about the project. You will be required to provide proof of income, bids, and photos of the problem needing to be corrected.
*
Indicates required field
Applicant Name
*
First
Last
Phone Number
*
Email
*
Are you disabled?
*
Yes
No
Address of home needing emergency repairs:
*
Line 1
Line 2
City
State
Zip Code
Country
Condition of dwelling:
*
Good
Fair
Poor
Year built?
*
Do you own this property?
*
Yes
No
How long have you lived in this property?
*
Number of people in family?
*
Number of children in family?
*
Annual income? (you will be required to show proof of income)
*
Who referred you to REPAH?
*
Phone Number
*
Please describe the specific repair that your home needs. (Provide photos if possible to repahjc@gmail.com)
*
Are you able to do the work yourself?
*
Yes
No
Not sure
If so, projected cost of materials:
*
Date submitted:
*
Submit
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2016 JCAR Family BBQ
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Bylaws/Policies & Procedures/Misc. Info
Buyer/Seller Disputes, Code of Ethics