A Brush With Kindness

Apply for help  
First Name:
Last Name:
Phone Number:
Phone Number Type:
Email Address:
Address:
City:
State:
Zip Code:
Do you own the home where you are requesting repairs?
Can you provide proof of homeownership? (e.g. Deed, Title or Property tax receipt )
Can you provide verification of income?
What is your monthly income?
Do you receive any type of public assistance? (e.g. Social Security, Disability, AFDC)
What type of repairs are you requesting? (please note we will only consider small exterior repairs)