Step 1 — Contact Your name* Phone* Email* So we can email you to confirm a time. Next Step 2 — Address & Work Street address City State ZIP code* Repair work description* — Select — Ramp Repair to existing Ramp- Wood Repair to existing Ramp- Aluminum Interior Door replacement (Client purchase door) Exterior Door Replacement (Client purchase door) Kitchen Cupboard Door Repair Kitchen Drawer Repair Interior Stair Repair 1-3 Build Exterior Wooden Stairs Fan Replacement (Client has fan) Light Fixture Replacement (Client has Fixture) Install GFI Outlets (Limit 3) Light Switch replaced (Limit 3) Smoke Detector install wireless Change Light Bulbs Garbage Disposal Replacement Kitchen Faucet Replacement 2 Handles Kitchen Faucet Replacement 1 Handle Bathroom Faucet Repair/Replacement 2 Handle Bathroom Faucet Repair/Replacement 1 Handle Replace General Pipes under sink (PVC only) Toilet Repair Handle/Inside Toilet Replacement Bathroom Grab Bars Tile Bathroom Grab Bars Fiberglass Bathroom Shower/Tub Caulking Spring Cleanup Opens April 1 until full Fall clean up Opens October 1 until full Interior Stair Railing 1-3 Steps Interior Stair Railing 10-12 steps Interior Stair Railing 12-15 Steps Outdoor Railings 1-3 Concrete Outdoor Railings 3-5 Concrete Outdoor Railings 6+ Concrete Outdoor Railings 1-3 Wood Outdoor Railings 3-5 Wood Outdoor Railings 6+ Wood Information and Resources Roof/Furnace/Water heater Information and Resources Other Other / not listed… Describe the work needed* Additional details (optional) Back Next Step 3 — Eligibility & details Type of home— Select —MobileApartmentTownhouseHouse Age range— Select —50 and below51–6566+ Veteran (applicant or spouse)— Select —YesNo Low-to-Moderate Income candidate— Select —YesNo Income CAP (Capacity)— Select —N/AYesNo Client can donate towards material— Select —YesNo Client intends to donate to SJH— Select —YesNo Referred by Back Submit request
