Jerusalem Project Application
Please fill out if you, or someone you know needs work completed on their residence.

Note: Not all applicants will be contacted by Jerusalem Project.  We have a very thorough process we use to select our projects.  We desire to be good stewards of our resources to bring honor to God in the best way possible.  We wish that we could meet everyone's needs; however, that is not possible at this time.

Please be completely honest in your application.  You are responsible for the information reported on this form.  

Jerusalem Project works completely for the Glory of God.  We do not charge homeowners for any of the materials, time, or labor involved.
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Resident's Last Name *
Resident's First Name *
Email Address
Resident's Phone Number *
(XXX) XXX-XXXX
Alternate Phone Number
(XXX) XXX-XXXX
Street Address *
Ex: 123 Main St
City *
State *
Use mailing abbreviation (Ex: SC)
Zip Code *
Type of work needed *
Select most appropriate or select "Other" and write in the answer
Describe in greater detail the work needed
Do you own or rent the residence? *
How many people live in the residence? *
What is the average household income? *
Have you ever applied for Jerusalem Project in the past? *
Have you or anyone in your household been convicted of a crime* or is there any condition that would make your residence unsafe for teenagers? *
*By crime, we mean anything other than speeding tickets, etc. NOTE: We work with the Cherokee County Sheriff's office during the project selection process.
If you answered "Yes" in the previous question, use the space below to explain.
How did you hear about Jerusalem Project? *
Select the one that best applies
Additional notes/comments
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