Nate’s Community Garage Application
Date
-
Month
-
Day
Year
Date
Name
First Name
Last Name
Spouse/Partners Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Employer
Email
example@example.com
Employer Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How many people live in your household?
How many over 18?
How many under 18?
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Vehicle Information
Make, model, year
Mileage
What is wrong with your vehicle?
License Plate number
Required Information
Verification of income is required in order to process your application. Please upload a picture or file of 90 days of income. Examples: paystubs, W2, child support,social security benefits, County support, etc.. along with a completed application
Veterans
Veterans are only required to show a copy of their VA card and a completed application.
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How did you hear about Nate’s Garage?
By pressing submit
I hear by give my consent to Nate’s Community Garage and it’s parent organization Nate’s Garage, LLC to share the information contained in my application form including any other material I have provided to support my application for aid with volunteers, staff members, church or agencies, in the exercise of its reasonable discretion, might see fit. I also give Nate’s Community Garage and it’s parent company Nates Garage, LLC consent to verify any information contained in this form, including any attachments or supplements I have provided, in order to determine the extent or legitimacy of my need. I also give permission to Nate’s Community Garage to take, use and publish any photos or video that may have been taken by Nate’s Community Garage for educational and promotional purposes.
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