NOTICE * Our online Weatherization application and Landlord questionnaire are being worked on, please contact our office at (920) 459-2780 to complete an application or questionnaire over the phone or to have an application mailed to you.
Fields with * are required fields.
Please fill in all applicable field(s) to you regarding your property below:
Company Name (if applicable):
What year was the property built?
What is the primary heating system?*:
Primary heating system other:
Has the heating system ever been replaced?*:
Has the owner been found eligible for Energy Assistance within the past year?
* If no, the property owner is required to contribute 20% of the total cost of weatherization work performed. *
Property owners are responsible for signing off on the work done through the weatherization program. If you will be designating a property manager to sign off on your behalf please list his/her name and title below:
Signing off completion work person's name and title:
How many living units does your rental property has?
Enter renter's full name:
Enter Renter's City/State/Zipcode:
Enter Renter's rent amount:
Enter Renter's # of household members:
Unit 2: (if applicable)
Enter unit 2 renter's full name:
Enter unit 2 renters address:
Enter unit 2 renter's City/State/Zipcode:
Enter unit 2 renter's phone:
Enter unit 2 renter's rent amount:
Enter unit 2 renter's # of household members:
** If additional space is needed, please attach another sheet of paper **
For 3 or more units, upload additional renter(s) information here:
** In order to prevent spam submission of this form, please enter the code you see below into the space provided below. **