Submit Your Nominee
Your Name:
*
First Name
Last Name
Your Email:
*
example@example.com
Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Nominee's Name:
*
First Name
Last Name
Nominee's Email:
*
example@example.com
Nominee's Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Nominee's Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Why Are You Nominating This Person?
*
To your knowledge, does the nominee own and live in this home as their primary residence?
*
Yes
No
What Does the Roof Currently Need?
*
Please Select
Minor repair
Full replacement
Storm or hail damage
Active leak
Not sure
What Real Barrier Is Preventing Them From Fixing the Roof Themselves?
*
e.g. insurance denial, fixed or limited income, medical or family hardship
Eligibility Confirmation:
*
To the best of my knowledge, the nominee is not a RainTech employee, subcontractor, immediate family member of one, or a Roofing for a Reason board member, and their household has not previously received a roof through this program.
Terms and Conditions:
*
I agree to be contacted by RainTech Roofing via call, email, and text. To opt out, I can reply "stop" at any time or click the unsubscribe link in the emails. Message and data rates may apply.
Submit
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