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2. 

3. Interest Form for the following Home Repair Programs:

   • Home Improvement Program (HIP)
   • Weatherization Assistance
   • Whole Home Repairs Program
   • York County Lead and Healthy Homes Grant
   • York City Owner-Occupied Rehab Program (YCOORP)
5. First Name*
6. Last Name*
8. Residential/Mailing Address*
10. City*
11. State*
12. Zip Code*
14. Phone Number*
15. Email Address
17. Notes / Brief Description of Needs (limit to 250 characters)*

19. After submitting, someone will contact you directly.

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20. Submit

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