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

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