Affordable Housing Water Efficiency Incentive Application

Customer Information

1. Organization Name *This question is required.

2. Legal Name (if different)

3. Customer Information

501c3 Tax Number

Utilities Account Name

Property Owner Name (if different)

Project Contact Name *This question is required.

Project Contact Phone Number *This question is required.

Project Contact Email Address *This question is required. This question requires a valid email address.

4. Organization Address *This question is required.

Street Address

Apt/Suite/Office

City

State

Zip

5. Last 5 Digits of Fort Collins Utilities Account Number
*Must be a Fort Collins Utilities commercial water customer to apply

6. Project Site

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

Zip *This question is required.

If the project has multiple addresses, please list them below.

7. Please check which application(s) you would like to complete. *This question is required.