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2. Community Development Block Grant

4. Please add my name and contact information to the ‘Interest List’ for the Handy helper Program. I understand that this is NOT an Application. I will be contacted when the application period opens up by the Program Administrator.

6. First Name
7. Last Name
9. Phone Number
11. Email Address
13. Address1
15. Address2
17. City
18. State
19. Zip

21. NOTE: In order to be eligible for the program, the home shall be owner-occupied and the household must meet the following income eligibility requirements.

23. Number of Persons in Household	Annual Gross Income Limit
    1	$66,850
    2	$76,400
    3	$85,950
    4	$95,500

25. The Handy Helper Home Repair program receives assistance from Cherry Hill Township’s Community Development Block Grant Program. The Program, funded by the U.S. Department of Housing and Urban Development (HUD), requires the Township to collect specific information about our program applicants and participants (income level, race, ethnicity). This information will be kept confidential and will only be provided to HUD in summarized reports.

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27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field