Habitat for Humanity Frederick

Home Repair Online Application

Please fill out the form below, and then submit the following information:

  • Most recent 3 paystubs, SS/Retirement Statement, etc. from ALL income sources
  • Most recent statements from ALL bills, even if they are annual or semi-annual (rent/mortgage, car payments, insurances (home, life, auto), tv, phone, internet, water/sewage, child care, real estate taxes, credit card payments, loan payments, electric/gas, etc).
  • A copy of your current homeowner’s insurance with premium

These items can be submitted by:

Fax: 301-698-1697

Email: info@frederickhabitat.org

Mail or Drop Off:
Habitat for Humanity of Frederick County
24 S. Wisner Street, #130
Frederick, MD 21701-0338

Online Application Form:

Home Repair
Address
Street Address
Apt/Unit
City
State/Province
Zip/Postal
Country
Cell Phone
Home
Habitat for Humanity Frederick
24 S. Wisner Street, Suite 130
Habitat for Humanity Frederick
Frederick, MD 21701
Habitat for Humanity Frederick
301-698-2449
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