Home
About Us
Network
Get Help
Services
Partners
News
Shop
Donate

Deutsch (LU)
English (US)
Español (MX)
Français (FR)
日本語
Português (PT)

Home
About Us
Network
Get Help
Services
Partners
News
Shop
Donate

Deutsch (LU)
English (US)
Español (MX)
Français (FR)
日本語
Português (PT)

Upgrade: Safe Home Application

Please fill out the form below to detail the level of need and upgrade application

Full Name*

Email*

Phone Contact*

Address of Home Repair or Upgrade Project*

Zip Code*

Applicant own the affected property?*

Yes

No, Not Affiliated

Residency*

Primary Residence

Secondary Residence

Rental (Short or Long Term)

Other

Insurance Coverage*

Insured, Fully Covered. Need education on what to do next

Insured, inadequate coverage

Insured, lapse in coverage

Uninsured, self funded. Need help identifying licensed contractors

Uninsured, low income

Uninsured

If not affiliated, or property not owned by applicant; enter owner details below

Description of Upgrade Need*

Notes or Personal Message

Description of Upgrade*

Safety

Access

Fire Safety

Necessary Items/Appliances

Disaster Preparation

Other

Explanation of Necessary Upgrades

Upgrade Area(s)*

Fire Safety Equipment

Safety Mechanisms (Grab bars, etc)

Thresholds, stairs or general access

Exterior Structure

Appliances

Other

High Risk Population*

Senior Citizen (65+)

Elderly (55+)

Veteran

First Responder

Active Duty Military

Military Reserves

Single Parent

Challenges with Health Conditions

Challenges with Disabilities

Challenges with Financial Resources

Low Income

Pregnant, single parent

Immigrant

First Generation

Family with 1 or more children under age 15

Foster Youth

Emancipated Minor

Limited English Profeciency, Non-English Speakers

Upgrade Application*

Upgrade Program

Upgrade Loan

Either

Self funded: need education or connect with local rebuid organization

Contact

Email address*

Location*

info@internationalfirefoundation.org

CONNECT WITH YOUR COMMUNITY

International Fire Foundation is a registered 501(C)3 charity

EIN: 99-0435238

Community Leader Resources