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.
- Waitlist Application
- Copy of Proof of Age
- As applicable - copy of Power of Attorney paperwork
- Waitlist Application
- Copy of Proof of Age
- Certificate of Need form
- History & Physical form
- As applicable - copy of Power of Attorney paperwork
- Waitlist/Transfer Change form
- Certificate of Need form
- History & Physical form
- As applicable - copy of Power of Attorney paperwork
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