Request an EAP Application by Mail

If you would like us to mail an application to you, please complete the form below.

Though we do not email applications, you can download one from the Energy Assistance & Water Assistance page of our website any time.

Request Form

Name

First Name *

Last Name *

Community Action Partnership of Hennepin County provides energy assistance for residents of Hennepin County. If you are not a Hennepin County resident, visit Minnesota Community Action Partnership's website to find the Community Action Agency that serves your community.

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Mailing Address

Country

Address Line 1 *

Address Line 2

City *

State/Province *

Postal Code *

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