Capitol Cares: 40th Year Roof Giveaway Nomination Form

Capitol Cares: 40th Year Roof Giveaway Nomination Form

To celebrate 40 years of trusted roofing, we’re giving back to the community that build us. To mark this milestone year, we're offering a free roof replacement to one deserving homeowner in Laramie County. Know someone who could use a helping hand? Nominate them using the form below and share their story with us. Let’s make a meaningful impact—together. Tell us why your nominee deserves the gift of a safe, reliable roof.
Consent & Acknowledgments
Consent & Acknowledgments: All Required*

I confirm the nominee owns the property at the address listed above.I understand that submitted nomination stories may be used in Capitol Roofing’s marketing materials.To my knowledge, the existing roof is not covered by insurance or eligible for an insurance claim.
Consent Validation

Please check all the boxes to proceed
Nominee Information
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address in Need of a Roof*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you nominating yourself or someone else?*

MyselfSomeone Else

Roof Condition
Estimated age of current roof:*
What roofing issues are present? Check all that apply.*

LeaksMissing ShinglesStorm DamageStructural ConcernsOther
Have any repairs been attempted?*

YesNo
Please explain:*

Consent & Acknowledgments
Consent & Acknowledgments:*

I have read and agree to the official rules and eligibility guidelines listed in this form.
Consent Validation

Please check all the boxes to proceed
Signature*
Date*

MonthDayYear
Date
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Should be Empty:

Consent & Acknowledgments