Republic Services Good Neighbors Home Repair Program

Habitat for Humanity Detroit is partnering with Republic Services to bring The Good Neighbor Initiative Home Repair Program to homeowners in the McDougall-Hunt and Poletown East neighborhoods. This partnership focuses on essential health and safety repairs that help residents remain safe, stable, and secure in their homes. Please complete this form to be considered for home repairs.

Please fill out the form below and we will review and reach out to you if you qualify.

Republic Services - Good Neighbor CHR
Please check which neighborhood you reside in:
Address *
Address
City
State/Province
Zip

Information for Government Monitoring Purposes

The following information is requested by the federal government for programs related to the purchase of homes, in order to monitor the organization’s compliance with equal credit opportunity and fair housing laws. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender may neither discriminate on the basis of this information, nor on whether you choose to furnish it or not. However, if you choose not to furnish it, under federal regulations the organization is required to note race and sex on the basis of visual observation or surname. If you do not wish to furnish the information below, please check the box below.

Armed Forces Service History

Armed Forces Service *

Housing Needs

Do you currently own your home and are listed as the owner of record on the deed? *
Is this your primary residence? *

AUTHORIZATION & RELEASE:

I understand that by submitting this application form, I am authorizing Habitat for Humanity Detroit (HFHD) to evaluate my eligibility for critical home repair services which includes a criminal background check, sexual offender check, and verification of homeownership and property tax status. I have answered all the questions on this form truthfully. The original or a copy of this form will be retained by HFHD even if the application is not approved. HFHD will only share the information on this application form with outside agencies offering services that I may be eligible for and as needed to provide preservation services I select and are part of the program.

I have reviewed the privacy policy *

You will receive email confirmation that your form has been submitted.

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