Renovation Application

What type of renovation are you applying for?

Mosque Renovation Madrassa Renovation Borehole Repair/Rehabilitation

Is this facility currently functional?

Yes, but needs improvement Partially functional Not functional at all

Full Name

Phone Number

Email Address

Your Role/Position

Facility Name

Full Address

GPS Coordinates (Optional)

How to get GPS coordinates:

Option 1: Click "Get My Location" to automatically detect your current location
Option 2: Use Google Maps - Right-click on the location and copy the coordinates
Option 3: Use your phone's GPS or maps app to find the coordinates

Coordinates help us locate your facility accurately for assessment

County

Please describe the current issues that need renovation

Urgency of Renovation

Critical - Facility is unsafe or unusable High - Major issues affecting functionality Medium - Needs improvement but functional Low - Cosmetic or minor improvements

Additional Information or Special Requests

How did you hear about our renovation program?

I confirm that the information provided is accurate and I consent to be contacted regarding this application

What We Renovate

Apply for Renovation

How to get GPS coordinates:

Mosque Details

Madrassa Details

Borehole Details

Mosque Renovation Needs

Madrassa Renovation Needs

Borehole Renovation Needs

Application Submitted Successfully!