Community Initiatives

Free Roof Rescue Nomination

Please fill this form out in its entirety to submit your application for our Free Roof Rescue program.

You can also click here to print a paper copy to mail in your nomination.

  • Nominee information






  • We will consider all information provided when making our decision and will especially take into account family situation, financial situation, serious hardships, and physical disability.



  • Your information


    If you are nominating yourself, please skip this section. If you are nominating someone you know, please provide your contact information below.





  • References (Optional)

    Please provide us with contact information for up to three references we may contact to assist in our decision.
    References will only be contacted if nominee is a finalist for a free roof.