2020 Project Request Form for Home Repair & Yard Work Projects (Responses)
What is Change the World?

Change the World Weekend of Service is dedicated to transforming our local community through acts of service and opportunities to build relationships with our neighbors. Over the weekend, volunteers from many community organizations will form work teams to help local residents by doing general exterior home repair, fence repair and yard work.

Projects will be selected based on homeowner need, availability of volunteers, and the ability of teams to complete the work. Homes selected to be repaired will NOT be responsible for supplying equipment, food, or drink to the team working on their home. Our volunteers will provide all necessary supplies.
Email address *
Service Projects for the Change the World Weekend of Service May 15-17, 2020
If you, or someone you know, are in need of assistance, please complete this form by March 15, 2020.
Recipient Name *
Your answer
Work Site Address including Town *
Your answer
Phone Number *
Your answer
Project Description *
Required
Please provide specific details about the work needed *
Your answer
I can help with the project by:
Your answer
Has your home been a project site for Change the World in the past? If so, when and what work was done?
Your answer
Certification of Property Ownership *
Required
Date of Certification *
MM
/
DD
/
YYYY
Name of Person Completing Application if not the Homeowner
This and the following questions are to be completed if the person completing the application is not the homeowner.
Your answer
Relation to the Above Applicant
Your answer
Contact Phone Number of Person Completing the Application if not the Homeowner
Your answer
Organization (if applicable) of Person Completing the Application if not the Homeowner
Your answer
Acknowledgement, Request for Service and Release 2020
In consideration for Change the World Allen volunteers providing services to me, I (we), on my own behalf and on behalf of my spouse, heirs, and estate do hereby release, waive, discharge and covenant not to sue Change the World Allen, all affiliated organizations, volunteers, successors and assigns, from all liability of any kind, for any claim, loss, damage, action, cause of action, or expense arising from, or in any manner relating to, directly or indirectly, the services or the performance thereof.
Please check to agree to the waiver of liability. *
Required
Homeowner Name - By completing this field, this constitutes an electronic signature. *
Your answer
A copy of your responses will be emailed to the address you provided.
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