Operation Fix It Application

FixIt_Logo_smallPlease complete all portions of the application, preview and then click on submit.  Keep in mind assistance is provided on a first come, first serve basis in addition to available materials and volunteers.  If your needs cannot be met at this time, you may be placed on a wait list.

The Operation Fix It Program possesses the right to refuse assistance if the applicant does not meet eligibility requirements or the nature of the request is deemed not to be in the best interest of the program or the City of Scottsdale.  The property owner on behalf of himself/herself, his/her heirs, personal representatives, principals, successors and assigns agrees to indemnify, defend and hold harmless the City of Scottsdale, its elected and appointed officials, officers, employees, agents and volunteers from and against any and all claims, losses, liability, costs, or expenses arising out of bodily injury of any person or damage to any property. Additionally property owner, on behalf of himself/herself, his/her heirs, personal representatives, principals, successors and assigns, hereby agrees to release any and all claims, demands, causes of action of any kind, known or unknown, real or imagined, it may have against the City of Scottsdale, its elected and appointed officials, officers, employees, agents and volunteers.
It is understood that this is a full and final release and discharge of property owner’s claims, including claims for costs and attorney’s fees, if any, all demands and causes of action, present or future, known or unknown, real or imagined, developed or undeveloped in any way arising out of the provisions of any services or assistance provided by the City of Scottsdale via the Operation Fix It Program.

The property owner also agrees to the following:
  1. Provide access to all areas of the property for City and Operation Fix It Program staff and volunteers, including but not limited to incidental access to interior areas if needed to access outside portions of the property.
  2. Accepts the service or assistance “as is” and will be personally responsible for making any changes or improvements.
  3. Be aware that some projects might not be completed, or may be canceled or rescheduled due to insufficient manpower, equipment, weather conditions, etc.
  4. Observe the work crew if physically able.
  5. Be on site while work is being performed or will provide notice to Project Coordinator.
  6. Will keep all pets away from the work crew.
  7. There will be no use of alcohol or any illegal substance on the day of the project.

Failure to observe this agreement will be grounds for cancelation of service.

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Head of Household Information
Required
Pick date
Required
Required
Are you receiving Social Security benefits?
Required
Are you receiving disability benefits?
Required
Spouse Information
Are you receiving Social Security benefits?
Are you receiving disability benefits?
Address and Phone Number Information
Required
Required
 
 
My home is a:
Required
Required
Required
Please list their names, date of birth and relationship to you: (only those that are over 18 years old)
Required
Do you operate a business out of this home? If YES, please provide business name and business license number.
Required
Is your home in foreclosure?
Required
Did you receive a Notice of Violation from Code Enforcement?
Required
Do you own other real estate property?
Required
If YES, please list properties below:
Required
I/we have reviewed the above application and agree to all of its terms and conditions and also certify that the information that I/we have provided in support of my/our application is true and correct to the best of my/our knowledge.
APPLICANT:
Required
CO-APPLICANT:
Required