2024 -- Needs Assessment
(Answer All Questions to Complete This Requirement)
First Name
Last Name
Which income group below best describes your household (check one)?
Please select...
Fixed income (depend on limited funds from Social Security , pensions, and/or savings to live)
Other/low income/underemployed
No income
Does anyone in your home (check all that apply):
Struggle with a medical need that requires you to keep your home at a certain temperature?
Have medical equipment that gets plugged in?
Does not apply
My home... (select all that apply)
Is affected by drafts, holes or damage near the windows, doors, floors, ceiling, or roof and/or lacks proper insulation
Has an inefficient or broken heating/cooling system; or uses something other than your regular heat source (space heater, stove, oven, etc.) to heat the home
Has water or dampness in rooms other than the bathroom and kitchen
Does not apply
In the past 12 months, have you been unable to repair your heating or cooling system due to lack of finances?
Please select...
Yes
No
What is your housing situation?
Please select...
Rent
Own or Land Contract
What type of home do you live in?
Please select...
Single Family
Multi Family (2 units)
Multi Family (3 or more units)
Manufactured
Apartment
The Home Energy Score report will provide recommendations for services that can help you save energy and money. Would you like a call to schedule your home energy score? Please note that apartment complexes and Multi Family (3 or more units) are not eligible.
Please select...
Yes
No
N/A
Each grant term the SWP MEAP requires the completion of the Energy Security Plan and the Energy Conservation and Money Management Workshops. How would you like to do those requirements?
Please select...
Mail
Online
Not Interested or already completed
Are any of your utilities DTE, SEMCO or UPPCO? If yes, would you be interested in saving money each month for 24 months by enrolling in an affordable payment plan?
Please select...
Yes
No
My household does not use any of these utilities
If your FPL is 110% or below, and you do not file a tax return, would you like information on applying for the Home Heating Credit?
Please select...
Yes
No
Do you need referrals for any other services?
Please select...
Yes
No
List of Referrals Needed
Contact Information