Form Submission

Please complete this brief application to be considered for eligibility in our home renovation assistance programs

We have an open door policy at Banance Foundation

Submission of this application does not guarantee acceptance into our home renovation assistance program. All applications are reviewed based on the eligibility requirements and program criteria listed below. Assistance is provided only to applicants who meet the applicable requirements and are selected for participation. Submission of an application does not create an obligation for our organization to provide services or funding. Program availability and assistance may also depend on available resources and funding.

Please fill out the short form below

First Name

Last Name

Email

Phone

Select all the option that represents your situtation Required

Low Income

Disability

Veteran

Disaster Relief

Do you own the home/property? Required

Yes

No

Banace foundation is required by our funders to ask for the information below. Your response is voluntary and confidential, and will not impact your eligibility. Please check all that apply. Required

I/We certify that the above information is true and correct to the best of my/our knowledge. I/We realize that failure to provide all the information requested could result in our application being invalid. I/We authorize you to check any references necessary to complete the processing of this application for the purpose of receiving housing rehabilitation and repairs through Rebuilding Together. I/We also understand that our address may be shared with organizations that support the service such as SMUD, Sacramento Housing and Redevelopment Agency, and Agency on Aging for purposes of tracking the impact. All other information will be kept confidential and used strictly for determining my/our eligibility for this program.

I freely consent to the unrestricted use by RTS and/or any person authorized by them of any photographs, recordings, interviews, videotapes, motion pictures or similar visual or auditory recordings of me created in connection with the Program, and I expect and anticipate no remuneration therefrom.

- Required

Acknowledge

Additional information

Thanks for submitting!