St. Timothy's Episcopal
OutreachCenter
A ministry of the congregations of the Diocese of Lexington
170 St. Timothy’s Rd., Irvine, Kentucky40336) 606-726-0607
The Ven.Bryant C. Kibler, Sr. Priest-in-Charge 607 Hwy. 1746, Irvine, KY 40336 606-464-9714
Application for participation in the St. Timothy’s
Work Camp Home Repair Program in 2017
Thank you for asking to take part in the Home Repair program of St, Timothy’s Episcopal Outreach Center. Our aim is to help to improve local housing with the aid of volunteer Mission Trips that visit St. Timothy’s and work in the surrounding area. Projects are undertaken with several criteria: urgency of needed work, availability of funds, ability and size of work camps, weather, and size of project. Projects are undertaken without regard to race, gender, age, marital status or religious affiliation. Since St. Timothy’s has received some funding from grants and is seeking more, we must ask that you complete all of the information asked below. Failure to complete the application will mean that you cannot take part in the program.
Name:
Address (No P.O. Boxes)
Phone Number (required)
Persons living in the household:
NameAgeSexRace
Do you own the house? Yes / No If no, who:
Do you own the land? Yes / No If no, who:
Age of the house (originally built):
Houses built before 1978 must be tested for lead paint to comply with Federal regulations.
How long have you lived in this location?
What work do you need done? (Be as specific as you can).
Can you provide any of the materials? What
Is anyone in the home employed, who?
Do you receive government assistance?
If yes, what kind?
What was the total household income, other than from the government, last month?
Has St. Timothy’s Church (not the Community Projects Committee) ever done repairs for you before?
If we are able to work on your house, you agree to have someone present(a relative is fine) while we do the work and to participate in at least one evening social gathering,(normally Thursday evening) with the group working on your house. If no one can be present, we will have to leave, even if work has begun.
I understand that those doing the work are volunteers and not professionals. Work will be done to the best of their ability but cannot be guaranteed. By signing below, you hold harmless St. Timothy’s Episcopal Outreach Center, The Diocese of Lexington and the volunteers for any damages which may occur as a result of their work or failure of materials. As the owner of this property, I agree with the above and give permission for St. Timothy’s Episcopal Outreach Center to perform the work as agreed or as able.
Signature of OwnerDate
Signature of resident (if not the owner)Date
For St. Timothy’sDate
Either give or mail this to Bryant Kibler at the address below.
The Ven. Bryant Kibler, Sr.
St. Timothy’s Episcopal Outreach Center
607 Hwy 1746
Irvine, KY 40336
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