Dan Chin Homes Foundation Application Form

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PLEASE SUBMIT BY 11/6/2020

Goal: To support the rent or mortgage for a person/family (or persons/families) experiencing a financial hardship.

Criteria:
- Must reside in the McFarland School District
- Must be experiencing financial hardship
- Can nominate yourself or someone else
- Open to everyone - no obligation to be a client of Dan Chin Homes

* Any Dan Chin Homes Foundation funding would be paid directly to the mortgage company/landlord. The recipient is responsible for understanding their circumstances and researching whether any Dan Chin Homes Foundation funding might have an adverse effect on the recipient's income taxes or government aid, if applicable.

Form completed by (include name, phone number, email address) *

Who are you nominating? Please include their name, address, other contact information, and how many people are in their household. *

How you know the person/family you are nominating (if you are nominating yourself, just put "self") *

Why are you nominating this person/family? Please describe the financial hardship/circumstance they are experiencing. *

How do you think support with their mortgage/rent being paid for would be helpful to them? If known, how much is their rent/mortgage? *

Is the nominee receiving additional grants or funding from other sources of which you are aware? *

Is there anything else you think is important for us to know?

I understand that if the nominee passes the initial screening, the nominee will be contacted for additional follow-up information. The applicant will be contacted prior to the Dan Chin Homes Foundation Board reaching out to the nominee. *

I understand the above statement.

I certify that the above information is true and accurate, to the best of my knowledge.

Required

Digital Signature *

Please type your full name below to digitally sign this form.

Submit

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