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Required fields are marked with an asterisk (*).
CONTACT INFORMATION
First Name *
Name you want to be called (if different from First Name)
Last Name *
Mobile Phone Number *
For example, 123-456-7890
Can you receive text messages at this phone number? *
Mailing Street Address *
Mailing Apt/Ste/Box Number
City *
State *
Zip Code *
Physical Address (for insurance, banking, etc.) if different from your Mailing Address -- Street, City, State, Zip
ELIGIBILITY REQUIREMENTS
If you do not meet a requirement, but believe your are an exception, then use the "ADDITIONAL COMMENTS" section below to explain to the Review Committee.
Do you have a valid DRIVER's LICENSE (for ID and for driving legally)? *
Are you currently, or have you ever been a full-time nomad who boondocks (camps without amenities -- electricity, water, trash, sewer)? *
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HOWA has observed that sending new nomads out after their new build, without mentorship, causes distress and sometimes abandonment of the nomadic lifestyle. Being nomadic and boondocking requires a necessary set of skills and experience for long-term success. Those skills and attributes encompass the areas of: computer competency, use of online mapping/GPS programs, budgeting, camping stewardship, basic mechanics, selection of state of residency, weather monitoring, flexibility, self-sufficiency, intuition, critical thinking, etc.
For the first and second BYOVs in the Spring and Fall of 2022, HOWA is not offering a mentorship program during the BYOV. Therefore, we are not accepting new nomads without at least 3 months of successful boondocking experience. Our plan is to develop a BYOV mentorship program as the program matures.
Will you commit to boondock in Pahrump for the full month of October 2022? *
Although BYOV staff will work hard to schedule all of your build(s) during the same time span, sometimes we are not able to do so. Also, sometimes a Build Slot unexpectedly becomes available and needs to be filled by a current Recipient for an extra Build Project.
Are you FINANCIALLY able to travel to and boondock in the Pahrump desert for the full month of October? *
LOGISTICS during the BYOV
Based upon the Build Project, Recipients need to empty their vehicles before they have their afternoon planning meeting with their Team at the Build Site on either Monday or Wednesday. If a vehicle is not sufficiently emptied for planning purposes or for the build at 8am the next morning, that Build Project will be cancelled.
HOWA provides each Recipient with an empty 10'X10' tent at the BYOV-Participant Camp on BLM land during the days of their Build Project.
Are you able to empty your vehicle in preparation for your requested Build Project(s)? *
The one exception is the 100W Portable Solar Power Supply/Panel; for that grant, you just need sufficient room to store the system.
Check the type(s) and number of pets you will have during the BYOV. Check all that apply. *
Do you want a volunteer to pet sit for you, at the BLM camp, during your build(s)? Recipient's pets are not allowed at the Build Site. You will be an active member of your Build Team. *
HEALTH and SAFETY
Do you have any conditions that are, or may appear to be contagious (skin, respiratory, viral, bacterial, etc.)? *
You have indicated that you have or may have a contagious condition (skin, respiratory, viral, bacterial, etc.). For the health and safety of all, provide a note from your doctor (on letterhead) with their signed approval of your participation to work in close quarters as part of a construction/installation team. Your doctor should include any instructions to protect you and the other workers who will be laboring next to each other.
In Part II of this Application, attach a scanned image or photograph of that doctor's note.
VEHICLE INFORMATION
Year, Make, and Model of your vehicle. *
Do you own your Vehicle? *
PRIORITIZING YOUR BUILD PROJECT REQUESTS
Below are eight Build Projects to choose from. For each project, indicate its priority level for you -- High, Medium, Low, or No Interest. You may be selected for more than one Build Project.
1) Solar Power System - Select Priority *
Solar Power System Choices *
If selected for a solar Build Project, list the items you expect to charge or power in your vehicle? For example, laptop, fridge, phone, hair dryer, heater, instant, etc. *
2) Venting from the Roof - Select Priority *
Ceiling Vent or 12v Fan? You MUST have available area on both roof and ceiling for vent (16"x16") ceiling or fan (20"x18") . *
3) Wall and Door Insulation - Select Priority? *
4) Ceiling Insulation - Select Priority *
5) Plywood Deck Flooring with Vinyl - Select Priority *
6) Plywood Platform Bed - Select Priority *
7) Plywood Shelving - Select Priority *
8) Privacy and Heat Reflection (Reflectix) for Windows - Select Priority *
ADDITIONAL INFORMATION
What ADDITIONAL INFORMATION do you think the Review Committee should know about you and your situation to help them in their selection process?
COVID: HOWA recommends that all BYOV participants follow current CDC guidelines to be safe and protect themselves and others from COVID infections.
Grounds for Dismissal from Build Events
Preamble
Homes On Wheels Alliance, Inc. (HOWA) strives to facilitate efficient Build Events in alignment with our Mission to serve those most in need, grounded in a community of care and compassion. Build Event Recipients have overwhelmingly demonstrated honest, responsive, and kind behaviors. However, a Recipient will be dismissed from participation or planned participation in a Build Event if the Recipient engages in certain problematic behaviors. This Grounds for Dismissal from Build Events policy outlines the conditions for such dismissals.
Grounds for Dismissal
If HOWA management determines a Recipient has demonstrated any of the below behaviors, that Recipient will be immediately dismissed from that Build Event or from participating in a planned Build Event:
1. Recipient violates or undermines the mission of HOWA;
2. Recipient is found to have provided false, misleading, or incomplete information to HOWA that HOWA relied on in selecting the Recipient for a Build Grant;
3. Recipient disrupts the activities of the Build Event; or
4. Recipient places other Build Event Participants at risk.
Examples
Examples of grounds for dismissal, include but are not limited to:
• Recipient's vehicle not sufficiently emptied in time for either their Planning Session or their Build Slot(s).
• Recipient is unresponsive to communications.
• Recipient does not accurately disclose financial and other resources available to Recipient.
• Recipient does not show up at scheduled appointment time or is significantly late.
• Recipient's pet is aggressive toward people or other animals, on leash or off leash.
• Recipient has a contagious condition that puts others at risk.
• Recipient participates in sexual or physical harassment in their jokes, words, or actions.
• Recipient violates the stated rules or boundaries of the Build Event.
After Dismissal
If at the time of dismissal, the Recipient was already granted a full or partial installation at that Build Event, then the Recipient must remove and return all previously granted supplies and materials within one week of dismissal. The supplies and materials must be returned in good condition at a mutually agreed upon time at the Build Event location.
Waiver
COMBINED LIABILITY AND PUBLICITY RELEASE
I agree to release and hold harmless Homes On Wheels Alliance, Inc., representatives of Homes On Wheels Alliance, Inc. and any and all volunteers at the Fall 2022 Bring Your Own Vehicle event held in Pahrump, Nevada. This includes any and all liability, claims, damages, demands, causes of action, costs and expenses (including reasonable counsel fees) I may have now and in the future, no matter how caused, arising out of, or in connection with the Bring Your Own Vehicle event. I further agree that in the event I bring a claim or lawsuit in violation of this agreement, I shall be liable for any attorneys’ fees and costs incurred by Homes On Wheels Alliance, Inc, representatives and volunteers in connection with such claim or lawsuit.
I understand that Homes On Wheels Alliance, Inc. will not obtain any liability, travel, automobile or other insurance on my behalf, and that I am fully responsible for obtaining my own insurance should I desire it (if applicable).
I accept the materials and labor for installations at my own risk and take sole and absolute responsibility for any injuries incurred out of my participation in the event or the use of the award(s), including, without limitation, the risk of personal injury and/or death, and WILL NOT HOLD SPONSOR, ADMINISTRATOR, OR ANY OTHER RELEASED ENTITY RESPONSIBLE.
In the event there are any disputes or controversies that arise between the parties pursuant to the terms of the aforesaid agreement, then the Parties are waiving their right to litigate these issues in court and instead elect to have these disputes resolved through arbitration.
I also consent to the use of my name, voice, image, biographies and/ or likeness (individually, together or with others) by Homes On Wheels Alliance or their assigns for advertising, publicity, and trade purposes in any and all media worldwide in perpetuity without any compensation payable to me. I understand that Homes On Wheels Alliance is not responsible for the award utility, quality or otherwise.
I understand that this Affidavit is intended to be as broad and inclusive as permitted by law, and I agree that if any portion of this agreement is invalid, the remainder will continue in full force and effect.
Furthermore, I understand this agreement and swear that it is true.
COMBINED LIABILITY AND PUBLICITY RELEASE
I agree to release and hold harmless Homes On Wheels Alliance, Inc., representatives of Homes On Wheels Alliance, Inc. and any and all volunteers at the Fall 2022 Bring Your Own Vehicle event held in Pahrump, Nevada. This includes any and all liability, claims, damages, demands, causes of action, costs and expenses (including reasonable counsel fees) I may have now and in the future, no matter how caused, arising out of, or in connection with the Bring Your Own Vehicle event. I further agree that in the event I bring a claim or lawsuit in violation of this agreement, I shall be liable for any attorneys’ fees and costs incurred by Homes On Wheels Alliance, Inc, representatives and volunteers in connection with such claim or lawsuit.
I understand that Homes On Wheels Alliance, Inc. will not obtain any liability, travel, automobile or other insurance on my behalf, and that I am fully responsible for obtaining my own insurance should I desire it (if applicable).
I accept the materials and labor for installations at my own risk and take sole and absolute responsibility for any injuries incurred out of my participation in the event or the use of the award(s), including, without limitation, the risk of personal injury and/or death, and WILL NOT HOLD SPONSOR, ADMINISTRATOR, OR ANY OTHER RELEASED ENTITY RESPONSIBLE.
In the event there are any disputes or controversies that arise between the parties pursuant to the terms of the aforesaid agreement, then the Parties are waiving their right to litigate these issues in court and instead elect to have these disputes resolved through arbitration.
I also consent to the use of my name, voice, image, biographies and/ or likeness (individually, together or with others) by Homes On Wheels Alliance or their assigns for advertising, publicity, and trade purposes in any and all media worldwide in perpetuity without any compensation payable to me. I understand that Homes On Wheels Alliance is not responsible for the award utility, quality or otherwise.
I understand that this Affidavit is intended to be as broad and inclusive as permitted by law, and I agree that if any portion of this agreement is invalid, the remainder will continue in full force and effect.
Furthermore, I understand this agreement and swear that it is true.
Check here to show you accept the terms stated above.