A Brush with Kindness - Home Repair Program Application

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Before you Begin

Thank you for your interest in Twin Cities Habitat for Humanity’s Tree Care Program. This application will help to determine your household's eligibility for grant funding for tree care needs, including trees affected by Emerald Ash Borer.


Note: While Twin Cities Habitat is not currently accepting new clients for home repairs, we do encourage you to complete the section on Page 6 about your home repair needs (in addition to tree care needs) so that we can connect you to resources provided by our referral partners.


If you submit an eligible application, tree care work will be scheduled as soon as possible after acceptance. Factors that could affect the start date of tree care work may include: Sign-on date, availability of subcontractors, weather, etc.


You will be asked to provide income statements and employment verification of all sources of income in the household (aged 18 and older).

Please have the following documents available as JPEG, PNG, or PDF file types on your device to upload into the application as you fill it out.
  • Color photo identification (driver's license, state ID, or passport) for each adult aged 18 and older
  • Last 4 months of income statements (8 statements if bi-weekly, 4 statements if monthly, etc.) for each adult aged 18 and older
Questions? For more information about acceptable forms of income documentation, visit our application help web page.
  • Current home insurance declaration pages
  • Proof of ownership (example: Property tax statement. Note: If the property is a mobile home, the original Mobile Home Title is required)
  • Photos (JPEG or PNG file types) of the areas in need of repairs including: 4 photos of the exterior of the house, 1-2 photos of the garage, and 1-5 photos of any other repair request(s).
  • *If a city citation or home insurance notification apply to your situation, submit the letter(s)
  • *If a member of your household is a Veteran, submit the DD-214 discharge form
  • *If referred by a partner agency, the agency may provide a Referral cover letter

Twin Cities Habitat for Humanity's Tree Care Program / A Brush With Kindness does not accept incomplete applications, or applications without supporting documentation.

Tip: Do not submit screenshots. Image quality is too poor, and documents must be legible. Instead, set up the document to "print" and select "save as PDF" instead of selecting a printer. Submit the PDF version instead.

Tip: If you do not have a printer and/or scanner available, you can complete forms using online tools such as, "DocHub - PDF Sign & Edit", or your preferred PDF form fill and sign mobile app.


If you submit an eligible and complete application, tree care work will be scheduled as soon as possible after acceptance. Factors that could affect the start date of tree care work may include: Sign-on date, availability of subcontractors, weather, etc.


Space is limited, apply now!


*Please note: Fully completed applications will be considered first come, first served until grant funding has run out. Incomplete applications will not be considered. If you have questions, please contact our support team at abwk@tchabitat.org or (612) 788-8169.

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If you have any questions while filling out this form, please contact our support team at abwk@tchabitat.org or (612) 788-8169.

Household Info
Home State                                 MN
Mortgage and Eligibility Information
A financial agreement in which a homeowner relinquishes equity in their home in exchange for regular payments, typically to supplement retirement income.
Equal Opportunity Statement

Page 3

The income of each adult member (aged 18 and older) will be used to qualify your household for the Twin Cities Habitat for Humanity Tree Care Program. 


If you need more information about which documents are required, visit our application help website or contact our support team at abwk@tchabitat.org.

Primary Applicant
The Equal Credit Opportunity Act, a federal law, requires that creditors obtain certain information about persons applying to purchase or finance a dwelling to be occupied by the applicant as a principal residence. For this reason, Twin Cities Habitat collects information about applicant’s race and ethnicity. This information will be removed from the application and will NOT be used in Twin Cities Habitat for Humanity’s decision to sell you a home. If you as the buyer(s) elect not to provide this information, the refusal will be noted on the application. Twin Cities Habitat is then required by law to note the race, national origin and gender of the applicant on the application on the basis of visual observation or the applicant’s surname.
For Veteran verification, submit DD-214 discharge form.
Any person who has a physical
or mental impairment that substantially limits one or more major life activities (walking, talking, hearing, seeing, breathing, learning, performing manual tasks, and caring for oneself); has a record of such impairment; or is regarded as having such impairment. In general, a physical or mental impairment includes hearing, mobility and visual impairments, chronic alcoholism, chronic mental illness, AIDS, AIDS Related Complex, and mental retardation that substantially limit one or more major life activities.
Any person who has a physical
or mental impairment that substantially limits one or more major life activities (walking, talking, hearing, seeing, breathing, learning, performing manual tasks, and caring for oneself); has a record of such impairment; or is regarded as having such impairment. In general, a physical or mental impairment includes hearing, mobility and visual impairments, chronic alcoholism, chronic mental illness, AIDS, AIDS Related Complex, and mental retardation that substantially limit one or more major life activities.
Hold Ctrl on your keyboard to select multiple
Employment
Please list your current employment history (last 4 months)
Employer / Self Occupation Start Date End Date (leave blank if still employed)
Employment Attachments

You are required to submit information about all income sources for the Primary Applicant, except for food stamps, adoption or foster care assistance, or unemployment.

Press Ctrl to select multiple
Please print, complete, and upload this document
TIP: If you do not have a printer and/or scanner available, you can complete the form using online tools such as, "DocHub - PDF Sign & Edit" via a Google Account.
Equal Opportunity Statement

Page 4

The Co-Applicant's income will help to determine your household's eligibility for Twin Cities Habitat for Humanity’s Tree Care Program.


If you need more information about which documents are required, visit our application help website or contact our support team at abwk@tchabitat.org.

Co-Applicant
The Equal Credit Opportunity Act, a federal law, requires that creditors obtain certain information about persons applying to purchase or finance a dwelling to be occupied by the applicant as a principal residence. For this reason, Twin Cities Habitat collects information about applicant’s race and ethnicity. This information will be removed from the application and will NOT be used in Twin Cities Habitat for Humanity’s decision to sell you a home. If you as the buyer(s) elect not to provide this information, the refusal will be noted on the application. Twin Cities Habitat is then required by law to note the race, national origin and gender of the applicant on the application on the basis of visual observation or the applicant’s surname.
For Veteran verification, submit DD-214 discharge form.
Any person who has a physical
or mental impairment that substantially limits one or more major life activities (walking, talking, hearing, seeing, breathing, learning, performing manual tasks, and caring for oneself); has a record of such impairment; or is regarded as having such impairment. In general, a physical or mental impairment includes hearing, mobility and visual impairments, chronic alcoholism, chronic mental illness, AIDS, AIDS Related Complex, and mental retardation that substantially limit one or more major life activities.
Any person who has a physical
or mental impairment that substantially limits one or more major life activities (walking, talking, hearing, seeing, breathing, learning, performing manual tasks, and caring for oneself); has a record of such impairment; or is regarded as having such impairment. In general, a physical or mental impairment includes hearing, mobility and visual impairments, chronic alcoholism, chronic mental illness, AIDS, AIDS Related Complex, and mental retardation that substantially limit one or more major life activities.
Hold Ctrl on your keyboard to select multiple
Employment
Please list your current employment history (last 4 months)
Employer / Self Occupation Start Date End Date (leave blank if still employed)
Employment Attachments

You are required to submit information about all income sources for the Co-Applicant, except for food stamps, adoption or foster care assistance, or unemployment.

Please print, complete, and upload this document
TIP: If you do not have a printer and/or scanner available, you can complete the form using online tools such as, "DocHub - PDF Sign & Edit" via a Google Account.
Equal Opportunity Statement

Page 5

The Additional household members' incomes will help to determine your household's eligibility for Twin Cities Habitat for Humanity’s Tree Care Program. Adult members of a household include: adult children, relatives, renters, and any person listed on the Title of the home.


If you need more information about which documents are required, visit our application help website or contact our support team at abwk@tchabitat.org.


Children, Dependents, Minors





Any person who has a physical
or mental impairment that substantially limits one or more major life activities (walking, talking, hearing, seeing, breathing, learning, performing manual tasks, and caring for oneself); has a record of such impairment; or is regarded as having such impairment.
Any person who has a physical
or mental impairment that substantially limits one or more major life activities (walking, talking, hearing, seeing, breathing, learning, performing manual tasks, and caring for oneself); has a record of such impairment; or is regarded as having such impairment. In general, a physical or mental impairment includes hearing, mobility and visual impairments, chronic alcoholism, chronic mental illness, AIDS, AIDS Related Complex, and mental retardation that substantially limit one or more major life activities.
__________________________________________________________________________________________
Additional Adult Household Members





Any person who has a physical
or mental impairment that substantially limits one or more major life activities (walking, talking, hearing, seeing, breathing, learning, performing manual tasks, and caring for oneself); has a record of such impairment; or is regarded as having such impairment.
Any person who has a physical
or mental impairment that substantially limits one or more major life activities (walking, talking, hearing, seeing, breathing, learning, performing manual tasks, and caring for oneself); has a record of such impairment; or is regarded as having such impairment. In general, a physical or mental impairment includes hearing, mobility and visual impairments, chronic alcoholism, chronic mental illness, AIDS, AIDS Related Complex, and mental retardation that substantially limit one or more major life activities.
For Veteran verification, submit DD-214 discharge form.
Employment Attachments

You are required to submit information about all income sources for all Additional Household Members aged 18 and older except for food stamps, adoption or foster care assistance, or unemployment.

Please print, complete, and upload this document
TIP: If you do not have a printer and/or scanner available, you can complete the form using online tools such as, "DocHub - PDF Sign & Edit" via a Google Account.
Equal Opportunity Statement

Page 6

Tree Care and Home Repair Needs




Proof of Ownership
Proof of Ownership
Briefly describe home repairs you need in the sections below. The Tree Care Program focuses only on structural pruning, removal, and replanting of trees.

Reminder: Twin Cities Habitat is not currently accepting new clients for home repairs, but listing your non-tree-care repair needs will allow us to help you connect with resources outside of A Brush with Kindness.

The opportunity to have the below work done is dependent on available program resources. 


The opportunity to have other repairs done is dependent upon capacity and available program resources. If we cannot provide that service, we will do our best to direct you to another organization.

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How did you hear about us?
Unless you give us permission to share your information with other organizations, your application will be kept confidential. If you select "Yes", you give Twin Cities Habitat for Humanity your consent to share the information you provide on this application with similar organizations in cases where A Brush with Kindness is unable to assist you.
Media & Publicity
If you qualify for services through our Tree Care Program or A Brush With Kindness program, there may be opportunities to share your story about your experience with the program (including photos of your family and home) for advocacy, marketing, and communication purposes.
City Staff / Source of Referral
A "referral partner" is a City, Healthcare, or Organization contact. If applicable, select "Yes". If you are working with family, a friend, or an acquaintance to complete the application, select "No".
Complete the following if you are not the homeowner, but you are assisting the homeowner to complete this application.
Name the Organization sending the referral, or list your relationship to the applicant. Anything else we should know?
If you are working with a Referral Partner, complete and upload any Referral Forms sent to you by your Navigator.
Disclosures & Attachments

Acceptable forms of photo IDs include: Minnesota State Driver’s License or State-Issued ID, and/or a Permanent Resident Card.
Please print, complete, and upload this document
TIP: If you do not have a printer and/or scanner available, you can complete the form using online tools such as, "DocHub - PDF Sign & Edit" via a Google Account.
Please print, complete, and upload this document
TIP: If you do not have a printer and/or scanner available, you can complete the form using online tools such as, "DocHub - PDF Sign & Edit" via a Google Account.
Once you click 'submit', the form may take a minute to prepare the summary page due to large file sizes.
DO NOT NAVIGATE AWAY FROM THE PAGE. You will have a chance to review and print/save your submission before you confirm submission on the next screen.
Equal Opportunity Statement
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