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  • 2023 PROJECT COOL BREEZE Application

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    This application is for Project Cool Breeze, which provides fans or air conditioners to those in need. The applicant provides their name, address, phone number, number in household, and eligibility criteria including lack of air conditioning, inability to purchase a fan/AC, food stamp eligibility, and not having received assistance in the last 3 years. If applying for an AC, the applicant must confirm being able to pay doubled/tripled electric bills and list financial assistance. Income and expense details are also required, and the applicant signs to verify the truth of the information provided.

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    Download, print and fill out this application for Project Cool Breeze.

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    This application is for Project Cool Breeze, which provides fans or air conditioners to those in need. The applicant provides their name, address, phone number, number in household, and eligibility criteria including lack of air conditioning, inability to purchase a fan/AC, food stamp eligibility, and not having received assistance in the last 3 years. If applying for an AC, the applicant must confirm being able to pay doubled/tripled electric bills and list financial assistance. Income and expense details are also required, and the applicant signs to verify the truth of the information provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    2K views1 page

    2023 PROJECT COOL BREEZE Application

    Uploaded by

    Live 5 News
    This application is for Project Cool Breeze, which provides fans or air conditioners to those in need. The applicant provides their name, address, phone number, number in household, and eligibility criteria including lack of air conditioning, inability to purchase a fan/AC, food stamp eligibility, and not having received assistance in the last 3 years. If applying for an AC, the applicant must confirm being able to pay doubled/tripled electric bills and list financial assistance. Income and expense details are also required, and the applicant signs to verify the truth of the information provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    PROJECT COOL BREEZE

    APPLICATION FOR A FAN OR AIR CONDITIONER


    Date: ______________ Please check one: Fan _____ Air Conditioner _____

    Name: ________________________________ Date of Birth: _____________

    Address: _______________________________________________ City: _________ State:____ Zip: _____

    Phone: _________________ Referred by: __________________________

    Number in household: ______ Veteran __Yes __No Branch _________________________

    Please check one or more of the following criteria:

    _____Home has no air conditioner.

    _____Unable to purchase fan or air conditioner

    _____Currently eligible to receive food stamps

    _____Have not received a donated fan or air conditioner (within three years)

    Please fill out the following information if you apply for an air conditioner:

    1. Are you financially prepared to have your electric bill double or triple if an air conditioner is installed in your home?
    _______________________________

    2. What financial assistance will you depend on to meet these bills? ______________________________

    INCOME: EXPENSES:

    Monthly Salary $___________ Rent/Mortgage $___________

    AFDC $___________ Utilities $___________

    Food stamps $___________ Medicine $___________

    Auto Payment $___________

    Child Support $___________ Cable $___________

    Insurance $___________

    Other $___________ Other $___________

    I verify that all information provided is true: _________________________________ _____________________

    Signature Date

    __________________________________________________________________________________________________
    OFFICIAL USE ONLY:

    Form of identification provided: __________________________ Date received: ______________________

    Date mailed: __________________________ Application 2023 #________________

    MAIL TO: PROJECT COOL BREEZE P.O. BOX 30576 CHARLESTON SC 29417

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