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ABOUT US
Our History
Testimonials
Assistance Application
Get Involved
Ways To Give
Adopt a Veteran
Events
Contact
Board of Directors
Meet the Staff
FAQ
Join Our Newsletter
Contact Us
Online Assistance Application
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Online Assistance Application
Before you proceed to the online application, answer these questions:
Are you a military veteran, a retired public safety officer, or a surviving spouse?
*
Yes
No
Do you live in and own your own home?
*
Yes
No
Does your home need minor repairs?
*
Yes
No
Veteran or Public Safety Officer Name
First
Last
Veteran's/Officer's Date of Birth
*
Annual Household Income
*
Is the Veteran or Public Safety Officer deceased?
*
Yes
No
• If yes, please provide a copy of the death certificate.
Spouse's Name
First
Last
Street Address
*
City
*
State
*
Alabama
Georgia
Zip
*
Phone Number
*
Email Address
*
What is the best time to contact you?
*
AM
PM
By phone or email?
*
Phone
Email
Did, or does, the veteran/public safety officer live in this home?
*
Yes
No
• Please provide a copy of your warranty deed.
If Yes, for how long?
*
How many people live in this home?
*
Please provide their ages and relationship to the veteran/public safety officer below.
*
Has House of Heroes previously done work on your home?
*
Yes
No
Are there any health issues we should be aware of?
*
Yes
No
If yes, please provide details below.
*
Needs: What are the top 5 needs you would like us to consider? Please rank from 1 to 5, with 1 being the top priority.
Interior cleaning
Gutters
Trash removal
Painting: Interior
Painting: Exterior
Plumbing fixtures
Flooring
Handicap fixtures
Handicap ramp
Interior doors
Windows
Porch railing
Pressure washing
Other
Once work is completed, we conduct an honor ceremony at your home. Please provide the following information for this purpose.
Family: Children (Names and Ages)
Where and when did you meet spouse?
Date of marriage:
Branch of Service
Last rank held
*
Date applicant entered active duty
*
Units served in
Occupation when entering service
*
Combat veteran?
*
Yes
No
Combat zone(s) and/or war(s) service in
*
Number of years served
*
Disabled?
*
Yes
No
If disabled, is it service related?
*
Yes
No
Date of retirement or honorable discharge
Special memory and/or event of applicant (military or civilian)
Awards and/or decorations
Required Documents
Please upload your DD214 (military) or proof of service (first responder).
Drop files here or
Select files
Max. file size: 50 MB.
Consent
*
I agree to the Homeowner Agreement & Acknowledgment.
I understand and acknowledge that House of Heroes Chattahoochee Valley is a volunteer-based nonprofit organization that provides minor home repairs and maintenance, free of charge, to eligible military and public safety veterans and/or their spouses. These services are offered as a community courtesy in response to a specific request for assistance.
I further acknowledge that all work is performed under a mutually agreed-upon scope of work between me, as the homeowner, and House of Heroes Chattahoochee Valley prior to the start of any project. I understand that volunteers are not professional tradespeople, and while they will perform all tasks to the best of their ability, the work may not meet professional or industry standards. Therefore, I agree to accept all work performed by House of Heroes Chattahoochee Valley volunteers in “as-is” condition upon completion.
In consideration of the services provided, I hereby release and hold harmless House of Heroes Chattahoochee Valley, its officers, employees, agents, and volunteers from any and all liability, claims, or causes of action arising from the work performed. This waiver applies to me, my heirs, assigns, executors, administrators, or any other individual or entity representing my interests.
I also agree to participate in the project to the extent that I am physically able, and I will encourage capable household members and relatives present to do the same. I understand that during project work, no alcohol, illegal drugs, or abusive behavior by anyone on the premises will be tolerated. Violation of this condition may result in immediate termination of the project, regardless of the work’s completion status.
I understand that House of Heroes Chattahoochee Valley operates through the generosity of private donors, local businesses, and community organizations, and that each project has a set budget that must be followed. Volunteers donate their time and effort as a way to say “thank you” for the sacrifices made in service to our nation.
Finally, I authorize House of Heroes Chattahoochee Valley to use photographs or video recordings of me, my family, and/or my property for promotional purposes, including but not limited to newspaper articles, advertisements, social media, websites, and television coverage, without expectation of payment or further consent.
Date
*
MM slash DD slash YYYY
Electronic Applicant Signature
*
First
Last
Number
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