I ♥ My Home CT Enrollment

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Summary

Participants receive support and data they need to make informed decisions, access financial resources, and complete their home energy improvement goals, step-by-step. We use this information in identifying the best programs for which you are eligible.

Participants agree to permit I ♥ My Home CT and contractors to share building information and performance for home improvements selected by the Participant. Participants agree to permit photographs, video, and other media of the home and improvements to be used for promotional and outreach purposes.

Privacy Statement
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Authorize us to help you!* This field is required.Sign here to confirm you agree to the NHS Privacy Statement and prepare forms for your review
Clear
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What is your email address?* This field is required.
example@example.com
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What is your first and last name?* This field is required.
First Name
Last Name
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What is the best phone number to reach you?* This field is required.
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What is the street address of the home we can help you improve?* This field is required.
Street Address
Apt, Unit, or Bldg
City
Connecticut
Connecticut
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Which utilities do you currently use?Select all that apply
Electric
Oil
Natural Gas
City Water/City Sewer
Propane
Wood or other biomass
Solar PV
Other
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When making decisions for your home, which is MOST important?* This field is required.
Overall Cost
Environmental Benefit
Comfort or Functional Improvement
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When making decisions for your home, which is the SECOND MOST important?* This field is required.
Overall Cost
Environmental Benefit
Comfort or Functional Improvement
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Have you completed a Home Energy Solutions assessment in the last two years?
YESNO
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What is one available date in the next two weeks when we can meet (in-person or virtually) at your home?
Date
Year
Month
Day
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What is a second available date in the next two weeks when we can meet (in-person or virtually) at your home?
Date
Year
Month
Day
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How did you hear about the program?* This field is required.
Please Select an Option
Please Select an Option
Word of Mouth
NHS of New Haven
City of New Haven Canvassers
Flier left at my door
CHEER Middletown
HeatSmart mailing
HeatSmart website
Love Hartford website
Love Hartford social media
Love Hartford event
City of Hartford (city hall, social services, newsletter, etc.)
Community org (NRZ, Hartford NEXT, senior center, community center)
Newspaper
Sign (flier, poster, street banner, etc.)
Home Contractor
System Smart/Michael Uhl
Other
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If "Other", how did you hear?Clarification to "How did you hear about the program?"
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What is the primary reason that you want to participate?* This field is required.
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What is your age?
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How many people live in your household?
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Are you on fixed income (retirement, social security pension, disability, etc)?
YESNO
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What is your household income range?
Please Select
Please Select
$19,999 or less
$20,000 - $24,999
$25,000 - $29,999
$30,000 - $34,999
$35,000 - $39,999
$40,000 - $44,999
$45,000 - $49,999
$50,000 - $54,999
$55,000 - $59,999
$60,000 - $64,999
$65,000 - $69,999
$70,000 - $79,999
$80,000 - $98,999
$99,000 - $119,999
$120,000 or more
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Are you Hispanic/Latino?
YESNO
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Please select your race:
Chose not to respond
Please Select
American Indian/Alaskan Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Multi-racial
Chose not to respond
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Are you a Homeowner?* This field is required.
YESNO
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What type of home do you have?
Condo
Single family house
Multi-family house
Duplex
Other
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What year did you purchase your home?
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Are you a Landlord?
YESNO
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Do you have Central Air?
YESNO
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What is the primary heating fuel?
Electric
Natural Gas
Oil
Propane
Other
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What is the primary heating system type?
Electric (Baseboards)
(Forced) Hot Air
Hot Water (Radiators)
Steam (Radiators)
Other
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What is the hot water heating fuel?
Electric
Natural Gas
Oil
Propane
Other
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When is your home used?
Year-round
Seasonally
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Are you renting your home?
YESNO
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What type of home do you rent?
Single family house
2-4 family house
5+ family building
Other
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Are you planning to purchase a home in the next 2-3 years?
YESNO
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How easy was enrollment in I ♥ My Home CT?
1
2
3
4
5
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Will you be willing to recommend us?
Yes
No
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Please verify that you are human* This field is required.
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Set Your Preferred Next AppointmentThis is a brief video or phone call meeting to ensure the right next steps are defined.
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Donate to share the benefits locally!Please consider making a gift to support I ♥ My Home CT today! Live smarter, not harder! Simply click below, select an amount, comment "I Heart My Home CT", and submit.
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