150 Osmun St Pontiac, MI 48342 | 248-338-1843

Please complete the form below if you are interested in participating in our Rock the Block program and having exterior repairs completed on your home. Some services are still available for renters.

Applications are currently being accepted for the June 20th and 21st Rock the Block event in the Ferry Farms Neighborhood, Pontiac. If you live outside of this area and the identified street boundaries of Ferry, Wilson, Midway, Central, Prospect, Edith Ave or Going St you will need to wait to apply at a later time if your neighborhood has been selected for a Rock the Block event.

Ferry Farms Neighborhood

Tuesday, June 20th, 2017 - Wednesday, June 21st, 2017

Contact Information

Household Information

adults
children

Program Eligibility

Please answer the questions below to provide Habitat with information about your current housing status, ability to pay for repair services and your willingness to partner with our organization.

Rock the Block - Home Repair Service Available

This program focuses on simple exterior home repairs that will be completed by our team of volunteers. Included in this program is a FREE energy audit from the Consumers Energy Helping Neighbors Program. A technician will come to your home to perform energy tests to help identify ways to reduce your energy costs. Some people are eligible for free energy upgrades. For more information about this FREE service, click here.

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

Financial Information

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




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, sexual offender check, verification of homeownership and property tax status. 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 Consumers Energy.

I understand that:

Information for Government Monitoring Purposes

The following information is requested by the federal government for housing programs in order to monitor the organizations compliance with fair housing law. You are not required to furnish this information, but 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 regulations this organization 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.