Neighbor to Neighbor Fund Sterling Municipal Light Department 5 Neighbor to Neighbor Fund "*" indicates required fields Name* First Name Last Name Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Household Members & AgesCurrent monthly incomePlease enter a number greater than or equal to 1.Annual Income from the Past YearPlease enter a number greater than or equal to 1.Current Balance in Savings AccountPlease enter a number greater than or equal to 1.Current Balance in Checking AccountPlease enter a number greater than or equal to 1.Are you or a household member a veteran?YesNoSupporting Documents Upload* Drop files here or Select files Accepted file types: pdf, jpg, jpeg, png, teic, gif, doc, docx, rtf, Max. file size: 25 MB, Max. files: 6. REQUIRED: Please include with your application a statement indicating your circumstances and reasons for requesting assistance, with copies of documents supporting your request, including proof of residency for at least one year and monthly bills and expenditures.PLEASE NOTE: 1) YOUR APPLICATION WILL NOT BE COMPLETE AND CANNOT BE CONSIDERED WITHOUT THIS STATEMENT AND 2) COPIES OF DOCUMENTS SUBMITTED WILL NOT BE RETURNED.Signature*Date*
