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UNITED WE PAINT- Carlsbad Nomination Form

For The Person You Are Nominating

Please provide as much information as possible.  All information is kept extremely confidential.
First Name
Last Name
Address
City
State
ZIP
Phone

Neighborhood Area
Owner Birthdate:
Are you disabled? Yes No

Homeowner Story:

(Share with us any disabilities, illnesses, or conditions, Share as much as possible!)

 
Names of Household Members:  
Name      Age  
Name      Age  
Name      Age  
Name      Age  
How many children (17 years of age and under) are living in your home? 
How many people living in your home are able to help paint (if any)?
Are you currently employed? Yes          No
Where are you currently employed?

Sources of Monthly Income (All information is kept confidential)
Social Security
SSI
Retirement
Interest Income
Public Assistance
Unemployment
Job
Other
Total Income Per Month

How did you hear about United We Paint?

Information On Your Home (Please provide as much information as possible)
Do you own your home?
Is this home your primary residence?
Age of Home? (years)
How long have you owned your home?
How much do you estimate your home is valued today?
Do you have a mortgage on your home?
If Yes, How much do you owe on your home?
When was your home last painted?
Your house is:

1 - Story

2 - Story

Mobile Home
Square footage of home?
Constructed of:

Wood Frame

Stucco

Brick

Other
Is there siding on your home?
Are there any external repairs needed prior to painting? Yes          No

IF yes, what repairs?

Only minor repairs can be made by volunteers and will be determined by United We Paint.

Your Information  (If Different Than Above)
First Name
Last Name
Address
City
State
Home Phone
Work Phone
Email
Relationship To Homeowner

  

Video & Pictures

 

 

The videos and pictures below showcase how Addison Avenue Federal Credit Union and United We Paint helped to provide a home makeover to Brandi and Dennis Herbst.  A 16-year Army veteran and purple heart recipient for bravery.

 

Addison Avenue Federal Credit Union Home Makeover

 

View Video

 

 

View Pictures

 

 

Next Event:  Addison Avenue Federal Credit Union is providing another home makeover to a deserving family in need.  This will be Addison Avenue's third of four events with United We Paint.

 

Location:  Larimer County, Colorado

Date:           July 25, 2009

 

Previous Events

 

Addison Avenue F.C.U.

Home Makeover Event

Loveland, CO

October 18, 2008

Click To View Pictures

Pacific Marine C.U.

City of San Marcos VIBE

San Marcos, CA

September 27, 2008

Valley First Credit Union

Ronald McDonald House

Fresno, CA

May 17, 2008

Click To View Pictures

C.S.T.

HELP of Ojai

Ojai, CA

February 21, 2008

Click To View Pictures

Foothill F.C.U.

Vincent Children's Center

West Covina, CA

November 17, 2007

Click To View Pictures

California Credit Union

Exterior Beautification

Leapwood Elementary

Carson, CA

Click To View Pictures

 

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