Address:

MWVCAA Weatherization
2551 Pringle Rd SE
Salem Or. 97302

 


Hours:
(By appointment only)

Monday - Thursday
7:00 AM to 5:30 PM
Closed on Fridays

 


Phone:

(503) 315-7055

Fax:
1-866-377-5456

General Email:
weatherization@mwvcaa.org

 

 
How to sign-up

 

To sign up for services please call (503) 315-7055 or
complete our Pre-Authorization form below

Note: Pre-application submission will simply add your home to the Weatherization waitlist and income will be verified when your name comes to the top of the waiting list. You will need to provide documentation during your eligibility appointment.

WEATHERIZATION PRE-APPLICATION


 APPLICANT INFORMATION
First Name:   Last Name:
Date:   Phone Number:
Address:      
City,State,Zip ,
County:      

 FUEL INFORMATION RELEASE

Please check all applicable Utilities:

 
Account No:   Account No:
  Oil
 


I hereby authorize you to release information on my fuel bills, both past and future, to Mid-Willamette Valley Community Action Agency Inc. Weatherization Program or its designee. I understand that this information will be used only to provide data for the above named agency, and no information obtained shall be made public in such a manner that the dwelling or occupants can be identified.




 Qualifications
Do you



Has your home been weatherized before?



Approximate Date:
How many people in your household?
Est. Monthly Gross Income:

What is your source of income?
Please check all that apply
  UnEmployment
  Pension/Retirement
  Child Support
  Dividends/Interest
   




  Anyone over the age of 60



Are any household members disabled?



  Are any household members Native American



Do you have the ability to leverage funds?



  Are any household members Active Military Duty




I understand pre application submission will simply add my home to the weatherization waitlist and that my income will be verified when my name comes to the top of the waiting list. I agree to provide any and all documentation as required when contacted for an eligibility appointment.


   

Clicking on Submit will open a new email window using your email client software. Simply send this email to submit your data.


   
   
   
   
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