Home Repair Request Home Repair Request Step 1 of 3 33% Client Contact InformationSolid Rock Ministries serves the West Michigan community in Ottawa County.Email(Required) Today's Date MM slash DD slash YYYY Name(Required) First Last Phone(Required)Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Do others live with you in your residence?(Required) Yes No How many years have lived in your home?(Required)Less than 1 Year1 Year2 Years3 Years4 Years5 Years6-10 Years11+ Years Work NeededWhich areas are in need of functional/safety repairs? (Check all that apply)(Required) Exterior of Residence (Ramps, siding, stairs, railing, skirting, etc.) Bathroom Bedroom Ceiling Electrical Flooring Kitchen Plumbing Roof Other Please describe what needs to be repaired?(Required) Next StepsWe will need to visit your home to assess the needed repairs if we feel like we can tackle your home issues.What is the best way to contact you?(Required) Email Phone Other When is the best time of day to schedule a visit?(Required) Morning Afternoon Please list another contact person (with phone number) if applicable. As the homeowner, I agree to provide/pay for the needed materials for the repair or modification being requested (lumber, replacement parts,etc). I agree and understand that I am responsible for the cost of needed materials.
