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Request an Application

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

To ask about your submitted application status, please call 952-930-3541.

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.

Request Form

First Name *
Last Name *
How would you like us to send an Energy Assistance application to you?

E-mail Address

Address Line 1
Address Line 2
Postal Code

  • GiveMN
  • United Way
    United Way
  • Community Action Partnership
    Community Action Partnership
  • MN Council Nonprofits
    MN Council Nonprofits
  • GuideStar

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