Home Repairs Application

Habitat for Humanity brings people together to build homes, community, and hope. Our repairs program partners with members in Sandusky County to improve a place they can call home.

Complete this appliction and submit all required documentation to

Sandusky County Habitat for Humanity
1515 Croghan St.
Fremont, Ohio 43420

Additional Required Documents
Proof of Homeownership
Income Documentation (for all residents)

Your Contact Information

First Name *

Last Name *

Email *

Gender

Date of Birth *

Address Line 1 *

Address Line 2

Phone *

City *

State *

Zip *

Co-Applicant

If applicable please enter the co-applicant's information here.

Co-Applicant Name The maximum length for the field Co-Applicant Name is 500 characters.

Co-Applicant Birthdate The maximum length for the field Co-Applicant Birthdate is 500 characters.

Co-Applicant Gender The maximum length for the field Co-Applicant Gender is 500 characters.

Co-Applicant Email The maximum length for the field Co-Applicant Email is 500 characters.

Co-Applicant Phone # The maximum length for the field Co-Applicant Phone # is 500 characters.

Other Household Residents

Please list other household residents here.

Name The maximum length for the field Name is 500 characters.

Relationship The maximum length for the field Relationship is 500 characters.

Birthdate The maximum length for the field Birthdate is 500 characters.