Applications and Waitlist Forms

How to Submit Completed Documents

  • Mail: Alaska Pioneer Homes – Central Office
    PO Box 110690,
    Juneau, AK 99811-0690
  • Fax: 907-465-4108
  • Deliver: To the Juneau Central Office (State Office Building) or at any of the Pioneer Homes across the state
  • Email: Call Central Office at 907-465-4416 to arrange for a secure email submission

The Alaska Pioneer Homes waitlist is broken down into "active" and "inactive" branches.

The active waitlist is for those who are ready to enter a Pioneer Home of their choice within 30 days of receiving an admissions offer. The inactive waitlist is for those applicants interested in moving into a Pioneer Home at some point in the future. *Note* There is no penalty for staying on the inactive waitlist. There is no limit on transferring between the two branches of the waitlist.

PDFInactive Waitlist Application Packet:

  • Waitlist Application
  • Copy of Proof of Age
  • As applicable - copy of Power of Attorney paperwork

PDFActive Waitlist Application Packet

  • Waitlist Application
  • Copy of Proof of Age
  • Certificate of Need form
  • History & Physical form
  • As applicable - copy of Power of Attorney paperwork

PDFInactive to Active Waitlist Transfer Packet

  • Waitlist/Transfer Change form
  • Certificate of Need form
  • History & Physical form
  • As applicable - copy of Power of Attorney paperwork

PDFVeterans Packet

Only applicable to veterans applying to the active waitlist for the Alaska Veterans and Pioneers Home

  • Alaska Pioneer Homes Veteran's Addendum form
  • Copy of DD214 form
  • VA 10-10EZ form

Individual Forms