My Habitat Clarkston – Minor Home Repair Application | Habitat for Humanity of Oakland County

Please complete the form below if you are in need of raking and/or minor exterior home repairs through the My Habitat Clarkston Impact weekend this Saturday, November 7^th and Sunday, November 8^th. You will receive a response from a Habitat Representative within 20 business says regarding your eligibility and the next steps.

Applications are currently being accepted for the My Habitat Clarkston Impact Weekend scheduled for

Saturday, November 7, 2020 – Sunday, November 8, 2020

Deadline to Submit Applications is September 21st

Contact Information

First Name*

Last Name*

Address*

City*

State*

Zip Code*

Phone*

Email*

Date of Birth*

Armed Forces Service*

I am currently serving in the Armed Forces

I previously served in the Armed Forces

I am the surviving spouse of an Armed Forces Servicemember

I have never served in the Armed Forces

Household Information

How Long Have You Lived in Your Home?*

How many adults, 18 years or older, live in your household?*

adults

How many children, 18 years or younger, live in your household?*

children

Household Disability Status (optional)

One or more household members has a disability

N/A

How did you hear about My Habitat Clarkston?*

My Habitat Clarkston Committee Member

Clarkston Community Church

Calvary Lutheran Church

Senior Center

Neighbor

Friend or family

Online

Another organization

None of the above

Program Eligibility

Please answer the questions below to provide Habitat with information about your current housing status and your willingness to partner with our organization.

Homeownership*

I am the legal owner of my home (my name is listed on the property deed)

I am NOT the homeowner; I am currently renting the home

I live in this home as my primary residence

My home is a mobile home located in a mobile home park

Willingness to Partner*

I will be available and participate in work done at my home alongside Habitat volunteers when scheduled

I am willing to participate in the event but I am not able to do physical work

I am willing to display partnership materials (lawn sign, stencil)

Impact Weekend - Home Repair Service Available

This program focuses on simple landscape clean-up and small exterior home repairs that will be completed by our team of volunteers. Below is a list of services available. Services are subject to change based on an assessment prior to the project start.

In Partnership with the Consumers Energy Helping Neighbors Program, Habitat for Humanity also offers a FREE energy audit, during which a technician can come to your home to perform energy tests to help identify ways to reduce your energy costs. Some people are eligible for free energy efficient upgrades. For more information about this FREE service, click here.

Below is a list of services available. Services and are subject to change based on an assessment.

My home is in NEED of one or more of the following services

Leaf Raking

Hedge/Bush Trimming

Gutter Cleaning

Gutter Repair

Minor repair to exterior of home or garage (weather and lead test permitting)

Minor repair to deck or fence

Additional Notes

Due to a high volume of projects taking place over the two days of Impact Weekend please keep in mind that any larger or extensive repair requests may have to be deferred to a later time to be a potential project for the Clarkston Community Church Handy Ministry.

Trash Pick-Up Availability

My home has trash pick-up available for:

Recycling Pick-Up

Waste Pick-Up

Yard and Organic Waste Pick-Up

Financial Information

Please select the sources of income for your household. Ex: Job, Social Security, Child Support, etc. Please list the amounts BEFORE taxes.

In an effort to assist the low-to-moderate income families in our community, please provide an estimate of your household income from any ongoing sources. This information will only be used for internal, application screening purposes to ensure eligibility within program parameters.

Income Source

How Often Are You Paid?

Amount Per Check

Income Source

How Often Are You Paid?

Amount Per Check

Income Source

How Often Are You Paid?

Amount Per Check

Income Source

How Often Are You Paid?

Amount Per Check

Authorization & Release* I understand that by submitting this application form, I am authorizing Habitat for Humanity of Oakland County (HFHOC) to evaluate my eligibility for home preservation services which includes a criminal background and sexual offender check. I have answered all the questions on this form truthfully. The original or a copy of this form will be retained by HFHOC even if the application is not approved. HFHOC will not share the information on this application form with any outside agency except as needed to provide preservation services I select and are part of the program such as the My Habitat Clarkston Committee and Consumers Energy.

I Agree

I understand that:

Only projects that can be completed in 2 days will be approved. The requested services and completion of my project is dependent on the number of volunteers that register for the event. Services must meet volunteer safety requirements and those that do not will not be completed.

Please Fill Out Your Name as a Signature*

Additional Demographic Information
For government monitoring purposes

The following information is requested by the federal government for housing programs, in order to monitor the organization’s compliance with equal credit opportunity and fair housing laws. You are not required to furnish this information, but you are encouraged to do so.

The law provides that an organization may neither discriminate on the basis of this information, nor on whether you choose to furnish it or not. However, if you choose not to furnish it, under federal regulation, this lender is required to note race and sex on the basis of visual observation or surname. If you do not wish to furnish the information below, please check the box below.

I do NOT wish to furnish this information

What race do you identify with?

Do you consider yourself Hispanic, Latino, Latina, or of Spanish Origin?

What gender do you identify with?

I have read Habitat for Humanity of Oakland County's Privacy Policy

I agree

My Habitat Clarkston – Minor Home Repair Application

Saturday, November 7, 2020 – Sunday, November 8, 2020

Deadline to Submit Applications is September 21st

Contact Information

Household Information

Program Eligibility

Impact Weekend - Home Repair Service Available

Trash Pick-Up Availability

Financial Information

Additional Demographic InformationFor government monitoring purposes

Additional Demographic Information
For government monitoring purposes