Home Owner Application

8230 Ridge Avenue

Philadelphia PA 19128

www.thephillyproject.org
Welcome to The Philadelphia Project's Homeowner Application. We help to make homes in Northwest Philadelphia safer, warmer, and drier, all year-round. Our primary focus is on homeowners who live in the Germantown and Mt. Airy neighborhoods, and we especially desire to be a blessing to single parents, the elderly, the disabled, and those struggling with hardships.
Name:*

First NameLast Name
Date of Birth*

MonthDayYear
Birth Date*

MonthDayYear
Must be located in the following Zip Codes:

19119
19126 (west of Broad St.)
19128
19129
19138
19141
19144 (west of Broad St.)
19150
Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number:*

Area CodePhone Number
Emergency/Alternate Contact (If we are unable to reach you)*

First NameLast Name
Emergency/Alternate Contact's Relationship to Applicant*
Emergency/Alternate Contact's Phone Number (If we are unable to reach you)*

Area CodePhone Number
Who referred you to The Philadelphia Project?
Marital Status?*
Ethnicity:*

Hispanic or Latino or Spanish OriginNot Hispanic or Latino or Spanish Origin
Race:*

American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteOther
Do you own the home you live in?*

YesNo
Are you current on your property taxes?*

YesNoNo, but on a payment plan
Are you or other resident a veteran?*

YesNo
How many people live at your home?*
Please list the NAME, AGE, and RELATION of those who live at your home below.
Resident #1
NAME, AGE, RELATION
Resident #2
NAME, AGE, RELATION
Resident #3
NAME, AGE, RELATION
Resident #4
NAME, AGE, RELATION
Resident #5
NAME, AGE, RELATION
Resident #6
NAME, AGE, RELATION
Please list any health problems or disabilities for any resident:
Please describe the top priority of work you would like done on your home:*
Must meet the "Very Low Income limit as outlined by HUD's income Limits Summary. As of 2024 these are:

Household size - Income limit

1 - $40,150
2 - $45,900
3 - $51,650
4 - $57,350
5 - $61,950
What is your average monthly household income?*
PLEASE PROVIDE DOCUMENTATION OF YOUR ENTIRE HOUSEHOLD’S INCOME for the last 12 months, e.g., pay stubs, pension, Social Security, Social Security Disability Income (SSDI), Supplemental Security Income (SSI) payments. This information should include yourself and all other household members.
How will we receive the documentation verifying your monthly household income?*

MailFile upload
You may upload the file digitally below. Otherwise, please refer to the address at the top of the form and mail us copies of your documentation.
Browse Files

Cancelof
Please read the following paragraph, then sign and date this application.
My signature indicates that I understand that The Philadelphia Project’s work crew members are volunteers, and that a majority of the work done on the homes is done by teenage students under adult supervision. I understand that their work may not be of professional quality, and that The Philadelphia Project may not be able to complete all the work I am requesting. I also understand that my house may or may not be selected for work. In addition, if my house is selected, I hereby agree to hold The Philadelphia Project, its board of directors, its staff, its volunteers, and its affiliated organizations, harmless of and from any and all liability of whatever nature may arise out of or result from their work. Furthermore, I understand that my stated income and all information above is complete and accurate, and if I provide fraudulent information, The Philadelphia Project has the right to deny service to my house.
Signature:*
Date:*
mm/dd/yyyy
Should be Empty: