Hammer with a Heart Homeowner Application

Contact Info
Home Information
Describe the all of tasks that need to be done, even if we cannot do them all. Please be as specific as possible.
Event Information
Household Income
Please fill out all income received by your household. You will be asked to provide verification of this income during the selection process.
$ annually
$ annually
$ annually
$ annually
$ annually
$ annually
$ annually
$ annually
$ annually
$ annually
Disabilities
To solicit volunteers and funds for Hammer with a Heart, it is essential that Project Home publicize this event. Are you willing to be photographed and interviewed regarding your involvement with Hammer with a Heart.
Please check the category that represents your ethnic background? (Response to this question is optional)
By typing my name, I recognize that in consideration of my voluntary participation in Hammer with a Heart, which is a charitable event, I agree to release all sponsoring organizations (including their officers, employees, members, and agents, all other volunteers, and homeowner participants) from all liability whatsoever which may arise out of or be connected with participation in this event and all activities related to it. I certify that I am the current owner-occupant of a single-family home in Dane County. I declare that the above household income for all members of the household is correct. I understand that in order to participate in Hammer with a Heart I may need to sign a five-year forgivable loan for the assessed value of the repairs performed, secured by a mortgage against the home. This loan will be forgiven at a rate of 20% per year provided that I own and occupy the home as my principal residence for five years. If I sell the home, transfer ownership, take equity out of, or move out prior to the five year period, the prorated balance of the loan will be due and payable to Project Home, Inc. The assessed value of the repairs will be determined after the home inspection has been completed and before said loan agreement is signed. I, the undersigned, certify subject to disqualification, that this information is true and correct to the best of my knowledge and believe, and that the provisions stated are accepted and agreed to.
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