ReNEW La Crosse Neighborhoods Application Packet and Guidelines 2019

Thank you for your interest in the ReNEW La Crosse Neighborhood Programs. In order to begin the process, you will need to complete a program application. You must live in the Lower Northside and Depot or Logan Northside Neighborhood to be eligible for ReNEW volunteer work. (SEE REVERSE FOR MAPS)

Please complete and return the application NO LATER THAN MAY 10, 2019, in order for your home to be considered by the ReNEW Application Committee.

Once your application is received and processed you will receive a letter regarding the status. Applications may not be processed until after the May 10th deadline. You may be asked for more information depending on the program recommendations. You can visit our Facebook page or our webpage at https://www.habitatlacrosse.org/renew-la-crosse.html to get information about volunteering and neighborhood events days.

If you are have any questions, please contact ReNEW at (608) 790-9702 or renewlacrosse@habitatlacrosse.org.  

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* 1. APPLICANT

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* 2. CO-APPLICANT

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* 3. TOTAL NUMBER IN HOUSEHOLD

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* 4. Do you live in in the Lower Northside and Depot or Logan Northside Neighborhood?

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* 5. Do you own or rent your home?

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* 6. Are you are anyone in your household a veteran?

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* 7. Are you are anyone in your household in the military?

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* 8. Are you or anyone in your household disabled?

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* 9. Are you or anyone in your household elderly (age 55 or older)?

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* 10. Certification:
I certify that the information provided in this application is true and correct as of the date of my signature on this application.

I acknowledge my understanding that any intentional or negligent misrepresentation of the information in this application may result in disqualification.

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* 11. Certification:
I certify that the information provided in this application is true and correct as of the date of my signature on this application.

I acknowledge my understanding that any intentional or negligent misrepresentation of the information in this application may result in disqualification.

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