• Minor Home Repair Application

    Metro Lutheran Ministry
  • Please complete the enclosed application. Copies of ALL required documents must be attached to your application. MHR assistance will be provided on a first applied, first served basis.

    MHR Assistance Available:

    1. Weatherization, energy efficient lighting

    2. Wheelchair ramps, handrails, other safety and accessibility repairs

    3. Minor home repairs including: broken windows, door locks, interior hand rails/grab bars

  • All documents are REQUIRED for consideration for MHR assistance. Please attach copies of the following documents

    Household Income must be at or below 150% of Federal Poverty Level

    Family Size  1  2  3  4 5  6
     Income Limit  $19,140  $25,860 $32,582 $39,300 $46,020 $52,740
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  • Before filling out the application, please read and sign your initials for each statement below.

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  • Client Consent and Release of Information

  • MAACLink is a computer system that is used locally as a Homeless Management Information System (HMIS). Use of an HMIS is required by the US Department of Housing and Urban Development (HUD) for agencies that receive HUD funding. MAACLink is not electronically connected to HUD and is only used by authorized agencies. All MAACLink users have received confidentiality training and have signed strict agreements to protect clients' personal information and limit its use appropriately.

    A Privacy Notice is available at participating agencies. It provides details on how member agencies and their employees handle client information and data sharing.

    I give permission to Metro Lutheran Ministry to collect and enter my personal and household information into the MAACLink computer system.

    I understand that the MAACLink system is shared with and used by authorized agencies in my community for the purposes of:

    1. Assessing the needs of low-income, homeless or other people with special needs in order to give better assistance and to improve their current or future situations.
    2. Improving the quality of care and service for people in need. 
    3. Tracking the effectiveness of community efforts to meet the needs of people who have received assistance.
    4. Reporting data on an aggregate level that does not identify specific people or their personal information.

    I understand that:

    • All agencies that use MAACLink will treat my information in a professional and confidential manner.
    • Signing this release form does not guarantee that I will receive assistance.
    • My information may be shared with a third party (utility provider, landlord, etc.) in order to process the service I have requested.
    • I have the right to a printed copy of my MAACLink file.
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  • Each MAACLink agency will ask you to sign this form at least annually. If after you give consent you decide you no longer would like your information entered into MAACLink, please complete the Client Revocation Form. If you do not revoke this authorization, it will automatically expire one year from the date you sign and date this form. 

  • Minor Home Repair Program

    Consent and Release Form
  • The undersigned, *   *, hereby releases and forever discharges the officer, directors, agents, employees, volunteers, and representatives, of Metro Lutheran Ministry and its Minor Home Repair program and the persons or entities providing materials or labor to the rehabilitative or renovative work provided to the undersigned residence, from all claims, demands, liabilities, actions, and causes of actions arising out of or relating to any injury, damage, or loss which the undersigned may sustain in any way connected with the undersigned's home participating in the MLM Minor Home Repair program.

    The undersigned agrees and understands that the undersigned is to assume all the risks and grant this release in consideration for whatever rehabilitative or renovative work provided to the undersigned's residence. The undersigned fully understands that all work provided is on a voluntary basis and the undersigned agrees to accept whatever work is provided. The undersigned understands that no promises or assurances have been made that any particular work will be done or that any particular result will be achieved.

    The undersigned also understands that the City will not be inspecting any work performed by volunteers or staff of MLM, unless required by law.

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  • Photo and Video Release

  • I,   *   *, hereby give my permission for Metro Lutheran Ministry (MLM) to use photographs or videotape of me or my children in printed materials and presentations. I also give my permission for Metro Lutheran Ministry (MLM) to quote me in printed materials or presentations.

    I understand there will be no compensation for me. All negatives, together with prints, video, and film are property of Metro Lutheran Ministry (MLM), or the entity or person authorized or designed by it, solely and completely. I also waive the right to inspect or approve any photo, video, or film.

    I release Metro Lutheran Ministry (MLM) from any and all liability associated with use of my photograph or video

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