Functionalmed

adding new life to years....

Community Assistance Property Nomination


Welcome to the 2008 functionalmed.org Clean-up Registration Page.


As part of our charitable work, functionalmed.org provides exterior spring cleaning, painting, and minor repairs for fixed-income elderly, low income and disabled property owners in the service area below.

Nomination of a property is easy....Just complete the form below and click submit. A representative of functionalmed.org will contact the owner and complete the application process.

Service Area

2008 Clean-up Service Area
" * " indicates a required field.
* First Name
* Last Name
* Street Address
* City
* State
Phone
* Email

The following maintenance / repairs need to be completed:
Please note, charitable services are provided for property owners only. All services are provided by volunteer workers under the supervision of Functionalmed.org's Community Based Assistance Division.