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0237 Cell 480. 253. 2232 Fax 480. 774. 0237 info rebuildingtogetherphx. org Name s of person requiring services Area No. Date received Age DOB Address City Zip Best Phone Alt Phone How did you hear of program email address Does someone in the home speak English Yes No Male Female Check all that apply over 60 physically disabled veteran or spouse of veteran lowincome must provide proof of income Applicant Demographics Optional Information The information below does not affect the selection...
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How to fill out safe home application
How to fill out safe home application
01
Start by obtaining a copy of the safe home application form.
02
Read the instructions carefully before filling out the form.
03
Provide all the necessary personal information such as name, address, contact details, and date of birth.
04
Fill out the sections related to your household members, including their names, ages, and relationship to you.
05
Answer any questions pertaining to your housing situation, such as whether you own or rent your home.
06
Provide details about your income and employment status.
07
If applicable, indicate any special needs or disabilities that you or your household members may have.
08
Attach any supporting documents required, such as proof of income or identification.
09
Review the completed form to ensure all information is accurate and complete.
10
Submit the filled-out application form to the designated authority either in person or by mail.
Who needs safe home application?
01
Individuals or families who are in need of safe housing.
02
People who are facing homelessness or living in unsafe conditions.
03
Victims of domestic violence or abuse who require a secure environment.
04
Individuals with disabilities or special needs who need accessible housing.
05
Low-income households or individuals who cannot afford adequate housing.
06
Anyone seeking assistance in finding a safe and secure home.
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