Home Repair Program Pre-Application : What We Do : Habitat for Humanity of Ravalli County

By completing the form below, you are submitting a pre-application for an Home Repair Program project through Habitat for Humanity. Providing false information could cause you to not continue in the application process.

Please be sure to fill out all required fields. Once you submit your pre-application, our Home Repair Program coordinator will review your information then follow-up with you to determine the next step in the application process. This is a pre-screening and is NOT a final Home Repair Program application.

First Name (Required)

Last Name (Required)

Email (Required)

Address (Required)

City (Required)

State (Required)

Zip (Required)

Phone (Home)

Phone (Work)

Phone (Cell)

Do you own your home?

Number in your household (Required)

How many people live in your household?

Please list the names, ages and genders of the people that live in the house. (Required)

What is your annual household income before taxes (e.g., paycheck, child support, food stamps, alimony, social security, disability, etc.)? (Required)

What are your monthly expenses and debt? Include house payment, credir cards, car payments, medical bills, insurnace, phone, utilities (Required)

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I am willing to partner with Habitat. I will work the required hours of "sweat equity" repairing my home.

Do you certify and declare to the best of your knowledge and belief that the information you provided is true, accurate and complete?

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