Nominate a Veteran for a Tiny Home
Please fill out the following form to nominate a Veteran for a tiny home with 2x4's for Hope.
Email address *
Untitled Title
2x4's for Hope
5700 South 24th St.
Quincy, IL 62305

217-617-8500

my2x4forhope@yahoo.com
I am nominating: *
Nominee name: *
Address: *
Date of birth:
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/
DD
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Cell phone: *
If you are nominating someone else, enter your name, address, and phone number:
Marital status: *
Number of children living with you (or nominee): *
Current housing: *
Do you use a wheelchair, walker, crutches, or have any other physical handicap? *
Branch of service:
Dates served:
Were you ever deployed?
Clear selection
Where were you deployed, if applicable?
Discharge:
Clear selection
If asked, can you produce a DD214?
Clear selection
Do you currently get VA benefits?
Clear selection
Employment:
Clear selection
Place of employment (if you answered full- or part-time above):
Are you a felon?
Clear selection
If "yes", enter city and state of arrest:
Explain felony if "yes":
If you are not currently a local resident, would you be willing to relocate if awarded this tiny home?
Clear selection
Please tell us in 500 words or less why the nominee should be awarded a tiny home. *
Submit
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