Community Comfort Program Application

  • Applicant Information

  • Personal References

  • Residence/Furnace Information

  • Applicant's Need for Assistance

  • Please describe any circumstances that may demonstrate any unusual or deserving situation that the selection panel should take into consideration.
  • Are you or the nominee related to a current or former employee of Carolina Comfort Air? If so, please give their name and the location they worked out of.
  • Date Format: MM slash DD slash YYYY