Free Air Conditioner Units

Qualifying low-income residents can apply to receive a free air conditioner unit.

Please enter your full legal name (no nicknames).

First name

Middle name

Last name

Please enter the address of the property for which you are requesting services or assistance for.

Address

Apartment, suite, etc. (optional)

City

State

ZIP Code

What is your email address?

What is your phone number?

Can be a cell phone or landline.

Select the option which best describes your relationship to the property:

I am the homeowner

I am filling this out on behalf of the homeowner

I am a renter

I am filling this out on behalf of the renter

1 of 6 Intro and identification questions