Ramp Up RI - Application

Ramp Up RI Application
Dear Applicant: Complete this application as accurately as possible to help us determine your eligibility for the South County Habitat for Humanity (SCHH) Ramp Up RI program.

Please note - we can only provide services to homes located within Washington County, Rhode Island.

If you have any questions regarding this application, please contact Homeowner Services Coordinator, Aliyya DeMartino at 401.213.6711 ext. 305 or Aliyya@southcountyhabitat.org

Is the home in need of a ramp located in Washington County? (SCHH can only provide services to those located in Washington County, RI).*

Yes - the home is in Washington County
Applicant Information
Applicant Name*

First NameLast Name
Applicant Date of Birth*

YearMonthDay
Date
Applicant address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you need approval to install a ramp? (i.e. from a landlord, property manager, homeowner association, etc.)*

YesNo
Please provide contact information for the approving entity OR upload a letter of permission in the uploads section.

Household Income*

	Household member name	Age (only include those 18+)	Total gross monthly income	Source of income (if applicable)
Person 1
Person 2
Person 3
Person 4
Person 5
Person 6

Required documents

This section lists documents required to submit as part of your application. Documents may be uploaded here or mailed to us at: South County Habitat, PO Box 68, Shannock, RI 02875.
Upload current driver's license or equivalent

Browse Files

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Upload proof of current homeowner's insurance (if applicable)

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Upload proof of income for all household members 18 and older. (As applicable please provide current award letters or 2 months of pay stubs).

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Upload written letter of permission to have ramp installed (if applicable).

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How did you hear about South County Habitat for Humanity?

Applicant agreements
Willingness to partner: By partnering with SCHH, you choose to share photos, videos, or stories about how a ramp impacts your family to support fundraising and advocacy for the RampUp Program. Participation is optional, and your decision will not impact your application.
Do you agree to the willingness to partner?*

I AGREEI DO NOT AGREE
Electronic Signature

Applicant authorization:I understand that by submitting this application, I am authorizing South County Habitat for Humanity to evaluate my need for a ramp. I understand that this evaluation will include a home assessment and income verification. I have answered all of the questions on this application truthfully.
Signature (use a finger, mouse, stylus, etc. to sign below)

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Ramp Up RI Application