• Home Repair Assistance Application

    Provide your contact details, property information, and a description of the repair request to check eligibility.

  • Applicant and Contact Information

  • Are you completing this application for yourself or on behalf of the homeowner?*
  • Format: (000) 000-0000.
  • Best Time to Contact You
  • Text Message Consent
  • Do you own and live in the home?*

  • Homeownership and Household

  • Current marital status*

  • Household, Eligibility, and Repair Details

  • Eligibility Note
  • Citizenship / Residency Status*
  • Has HopeWorks Ever Serviced This Home?*
  • Upload a File
    Drag and drop files here
    Choose a file
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  • Do Any Property, Insurance, Ownership, Legal, or Contractor-Safety Concerns Apply?*

  • Documents, Authorization, and Signature

  • Are you able to upload your documents now?*
  • Supporting Documents
  • Privacy Notice
  • HopeWorks Non-Discrimination Statement
  • Legal Attestation
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