Skip to content
Habitat For Humanity of TillamookHabitat For Humanity of Tillamook
  • Who We Are
    • Local & Global Impact
    • General Info
    • Meet Us
    • Blog and Media
    • Community Partners
    • Contact
  • What We Do
    • Homeownership
    • Ramps & Rails
    • ReStore
    • Advocacy
    • Global Impact
    • Local Resources
  • Get Involved
    • Donate
    • Volunteer
    • Events
    • Sponsorship
  • Donate
  • restore
  • Donate
  • restore

Full Client Application Form

Step 1 of 7

14%
  • MM slash DD slash YYYY
  • Please enter a number from 1 to 12.
  • NameRelationshipAge 
  • Special Needs

  • Are you, or is any member of your household:
  • Household Income

  • For instance, the most recent income tax return, monthly social security statement, other retirement income statements, employment check stub. Please note on attached statements frequency of income).
  • MM slash DD slash YYYY
  • Name of bank, savings and loan, credit union, etc.AddressAccount NumberCurrent Balance ($) 
  • Is asset paid off:
  • Is asset paid off:
  • Is asset paid off:
  • Is asset paid off:
  • Type$ 
  • Family Background

  • Habitat for Humanity screens all potential applicants on the National Sex Offender Public Registry.
  • Home Information

  • Repairs Needed

  • By completing this application, I certify that the information I have provided on this application is accurate and that I own the property at the address provided. I have no present intention to move or offer my home for sale for at least three years. I confirm that, except for the conditions listed in this application, my home is a safe place for volunteers.

    Completion of this application signifies that I understand that if I am approved and there are costs for the repairs, I agree to pay for the cost of the repairs and may be able to qualify for a no interest loan for those costs and make monthly payments until the balance is paid off.

    I understand that the people who may work on my house may be unpaid volunteers or staff; that few, if any are skilled in the building trades, and that ‘Ramps & Rails’ makes NO WARRANTIES, EXPRESSED OR IMPLIED REGARDING ANY MATERIALS USED OR WORK DONE BY ANYONE AT MY HOUSE.

    I understand that the people who may work on my house may be unpaid volunteers or staff; that few, if any are skilled in the building trades, and that ‘Ramps & Rails’ makes NO WARRANTIES, EXPRESSED OR IMPLIED REGARDING ANY MATERIALS USED OR WORK DONE BY ANYONE AT MY HOUSE.

    I also understand that Habitat for Humanity screens all applicant families on the sex offender registry. By completing this application, I am submitting myself to such an inquiry. I further understand that by completing this application, I am submitting myself to a criminal background check.

    I hereby release Tillamook County Habitat for Humanity and any of its affiliated organization from all actions, claims or demands that I, my assignees, heirs, guardians, and legal representatives now have or may hereafter have for injury or damages resulting from my participation in any Tillamook County Habitat for Humanity activities.
  • Completion of this application signifies that I understand that if I am approved and there are costs for the repairs, I agree to pay for the cost of the repairs and may be able to qualify for a no interest loan for those costs and make monthly payments until the balance is paid off.

    I understand that the people who may work on my house may be unpaid volunteers or staff; that few, if any are skilled in the building trades, and that ‘Ramps & Rails’ makes NO WARRANTIES, EXPRESSED OR IMPLIED REGARDING ANY MATERIALS USED OR WORK DONE BY ANYONE AT MY HOUSE.

    I understand that the people who may work on my house may be unpaid volunteers or staff; that few, if any are skilled in the building trades, and that ‘Ramps & Rails’ makes NO WARRANTIES, EXPRESSED OR IMPLIED REGARDING ANY MATERIALS USED OR WORK DONE BY ANYONE AT MY HOUSE.

    I also understand that Habitat for Humanity screens all applicant families on the sex offender registry. By completing this application, I am submitting myself to such an inquiry. I further understand that by completing this application, I am submitting myself to a criminal background check.

Copyright 2022 © Tillamook County Habitat for Humanity
  • Who We Are
    • Local & Global Impact
    • General Info
    • Meet Us
    • Blog and Media
    • Community Partners
    • Contact
  • What We Do
    • Homeownership
    • Ramps & Rails
    • ReStore
    • Advocacy
    • Global Impact
    • Local Resources
  • Get Involved
    • Donate
    • Volunteer
    • Events
    • Sponsorship