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Menu
Home
Habitat for Humanity
About
Board
Staff
Donations & Gifts
News & Information
Events
Blog
Photos
Volunteer Opportunities
Resources
FAQs
Habitat Restore
About Habitat Restore
Habitat Restore Staff
Restore Contact Info
Shop
What To Expect
What We Sell
Assisted In-Store Pick-Up & Load-Out
Discount Days
Delivery
Customer Loyalty Program
Donate
Donations We Accept
Donations We Don’t Accept
Areas We Pick Up From
Volunteer Opportunities
Restore FAQs
Volunteer
Volunteer Opportunities
Habitat Build
Habitat Community Revitilization
Restore Volunteering
Board Service
Community Service Volunteers Local
Special Programs
Internships
Hire
Donate
Emergency Repairs Program
Applicant Information
Name
*
Name
First
First
Last
Last
Address
*
Address
Address
Address
City
City
State/Province
State/Province
Zip/Postal
Zip/Postal
Phone
*
Email
*
Monthly Income
*
*
By checking this box I certify that I rent, and do not own my home.
Landlord Name and Phone #
*
What repairs are needed?
*
1. Race (select one or more)
*
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
I prefer not to provide this information
2. Ethnicity
*
Hispanic or Latino
Not Hispanic or Latino
I prefer not to provide this information
*
I understand that the Oklahoma Community Cares partnership grant is specifically for renters. CCHFH will process all applications and notify you if there are any questions.
*
I understand that CCHFH must receive my Landlord's Work Authorization signed form before any work will be completed.
Once your application is received, one of our staff members will contact you to schedule a meeting and complete any additional application information needed.
If you are human, leave this field blank.
Submit
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