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HEAT Application

Please be sure to click the submit button at the bottom once you have completed the application.

Applicant's Full Name:

Street Address:

City:

State:

Zip:

Email Address:

Phone Number:

Total 2024 Annual Household Income:

Amount Requested:

Purpose of Request:

Number of occupants in household, including yourself:

I certify that I am a member of Meridian Trust Federal Credit Union. The information I have provided is true and correct. Any misrepresentation or misinformation supplied by me could constitute immediate return of all grant money and forfeiture of eligibility in the program.

Applicant Signature

Hold down your left mouse button and drag the cursor to add your signature.

Today's Date

NOTE: Please attach copies of heating bill(s) or invoices to substantiate request of funds.

To upload: Please take a picture or screenshot of heating bills or invoices. Then click "Upload File" and upload the picture.

Upload File

Supported file types: JPG, PNG, GIF, JPEG.

Your submission has been received.

If you have any questions, call us at 800.726.5644 or send an email.

Grants Application

Grants Application

Grants Application

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HEAT Application