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 Habitat Helping Hands Inquiry Form

 Habitat Helping Hands Inquiry Form

This form gives Helena Area Habitat the information needed to determine if you qualify for Helena Habitat Helping Hands Program. This is NOT an emergency or crisis-based resource. There can be no guarantees of eligibility made at this inquiry stage.

Click here to download the form or fill out the form below.

Homeowner Information:

Please list all household members and all sources of income:

Sources include, Employment, SSI, SSDI/Disability, Child Support, Kinship Care, Retirement, Workers Compensation, Unemployment, Etc.

Information about your home:

Habitat Helping Hands volunteers provide the labor for no cost; however, the homeowner(s) is responsible for material costs.

If not, ask Helena Habitat’s Program Manager how to qualify for funding assistance: Contact Cassie Elliott at (406) 204-7314 or email CElliott@HelenaHabitat.org
With my signature, I certify that the information that I provided is accurate and that I own the property at the address listed on this form. I understand that by submitting this inquiry, I am authorizing Helena Area Habitat for Humanity to evaluate my home’s need for minor accessibility repairs. In recognition of the voluntary nature of Habitat Helping Hand’s, the undersigned waives and releases any and all claims of any kind or nature whatsoever they might have against Helena Area Habitat for Humanity, and any board members, officers, employees, agents or volunteers, arising from the repair work to be preformed by the Volunteer, including by not limited to claims for relief based upon claims for breach of contract, breach of warranty, negligence, claim for personal injury, claims for property damage and claims for additional repair expense.