2020 Project Request Form for Home Repair & Yard Work Projects (Responses)

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What is Change the World?

Change the World Weekend of Service is dedicated to transforming our local community through acts of service and opportunities to build relationships with our neighbors. Over the weekend, volunteers from many community organizations will form work teams to help local residents by doing general exterior home repair, fence repair and yard work.

Projects will be selected based on homeowner need, availability of volunteers, and the ability of teams to complete the work. Homes selected to be repaired will NOT be responsible for supplying equipment, food, or drink to the team working on their home. Our volunteers will provide all necessary supplies.

Email *

Service Projects for the Change the World Weekend of Service May 15-17, 2020

If you, or someone you know, are in need of assistance, please complete this form by March 15, 2020.

Recipient Name *

Work Site Address including Town *

Phone Number *

Project Description *

Mowing / edging / landscaping

Trimming tree limbs

Dead tree removal

Exterior painting

House siding / trim repair

Fence repair

Other:

Required

Please provide specific details about the work needed *

I can help with the project by:

Has your home been a project site for Change the World in the past? If so, when and what work was done?

Certification of Property Ownership *

I certify that I am the owner, or have obtained approval from the owner, of the job site concerning the above requested project. I understand this is only a job request, and I will be contacted by a Change the World volunteer who will review this request and determine if we can complete the project. Change the World is unable to assist those renting a house.

Required

Date of Certification *

YYYY

Name of Person Completing Application if not the Homeowner

This and the following questions are to be completed if the person completing the application is not the homeowner.

Relation to the Above Applicant

Contact Phone Number of Person Completing the Application if not the Homeowner

Organization (if applicable) of Person Completing the Application if not the Homeowner

Acknowledgement, Request for Service and Release 2020

In consideration for Change the World Allen volunteers providing services to me, I (we), on my own behalf and on behalf of my spouse, heirs, and estate do hereby release, waive, discharge and covenant not to sue Change the World Allen, all affiliated organizations, volunteers, successors and assigns, from all liability of any kind, for any claim, loss, damage, action, cause of action, or expense arising from, or in any manner relating to, directly or indirectly, the services or the performance thereof.

Please check to agree to the waiver of liability. *

I have read the statement above and have requested services through Change the World Allen.

Required

Homeowner Name - By completing this field, this constitutes an electronic signature. *

A copy of your responses will be emailed to the address you provided.

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