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Nominate a Neighbor for a
FREE
House Cleaning!
Nominee Name
*
Is the Nominee 65 or older?
*
A
Yes, they are 65 or older
B
No, they are under 65
Is the Nominee currently residing in Indiana?
*
A
Yes, they live in Indiana
B
No, they live outside Indiana
Nominee Address
*
Nominee Phone Number
*
Your Phone Number
*
Nomination Story
*
Home Condition Assessment
*
To ensure the safety of our staff and volunteers, are you aware of any major structural hazards, biohazards (such as mold or hoarding issues), or other health/safety concerns in the home?
No known hazards
I am unsure or there are potential concerns
Submit
