Apply - if you have a problem filling out form please email: info@kingdombuilderscny.org

Application Date *

Name *

First

Last

Single Line Text

Address of Residence *

Address Line 1

Address Line 2

City

State

Zip Code

County *

Email Address *

Age *

Phone *

Type of Phone Connection *

Cell
Home

Total Household Monthly Gross Income (all residents 18 or older) *

Total Number of Income Earners

Total # Household Residents *

Household Members (Other than Applicant) Information:

Name

Age

Relationship to Applicant

Name

Age

Relationship to Applicant

Name

Age

Relationship to Applicant

Name

Age

Relationship to Applicant

Mission Statement: KB of CNY ministry exists to serve homeowners in the greater Oneonta area by providing quality labor to address construction needs that they are unable to accomplish by their own means. Although the practical focus is on construction, the spiritual focus is on building relationships with those served, with the end goal of demonstrating the love of Christ through ministry.

Modifications or Repair Description

What modifications or repairs are needed? *

Home Type *

Frame
Mobile Home

Number of stories *

Year Home was Built: *

Do you own the property that is being considered in this application? *

Do you own property other than your residence? *

Do you currently reside in the home for which you’re requesting this assistance? *

Do you currently have a lien/mortgage on this home? *

Are Payments up to date and current? *

Are the taxes paid up to date? *

We require home insurance for this application to be accepted! Is the property currently insured? *

Do you have any renters? *

Do you have any dogs on premise? *

If yes, how many?

Breed of Dogs

How did you hear about Kingdom Builders? *

Kingdom Builders Website
Your church
Office of the Aging
Other

Have you ever applied to Kingdom Builders in the past? *

Have you applied to any other agencies for help with these problems on your home? *

I/we certify that: 1) I/we own the property this property or I/we have been granted lifetime residency in the property.

2) All statements on this Application are true, accurate, and complete to the best of my/our knowledge and that any intentional misrepresentation of material information contained on this form will be grounds for disqualification.

3) My/our permission is granted to allow KB of Central NY to have access to my home o plan modifications and other improvements.

4) I/we grant KB of Central NY permission to take beginning, progress, and after photos of work done on my home.

Signature *

Date of Signature

Apply – if you have a problem filling out form please email: info@kingdombuilderscny.org