H2O Assistance Application
The H2O program is an assistance program in partnership with United Way of Grant County and Marion Utilities. The program is designed to help support customers toward financial stability through partnership and planning. The H2O Community review committee meets monthly, on the second Tuesday of each month. Customers will be notified of approval or denial within 30 days of receiving an application. If the customer is facing disconnection, the customer will also need to talk to the Marion Utilities customer service team to set up a grace date and payment arrangement until their H2O application can be reviewed. *If you are approved, this is a one time assistance program*
*If you are approved, this is a one time assistance program*
I am giving permission for the United Way of Grant County to have access to my utility information for the purposes of the H2O program.
Street Address Line 2
State / Province
Postal / Zip Code
Please enter a valid phone number.
Account Number with Marion Utilities
Source of income
Number of People in your household and ages
So we can best help you, what are the circumstances that are preventing you from making your payment?
Do you have a leak or other water-related issue that is causing your water bill to be higher than normal?
Have you received H2O funds before? If so, when?
Have you made payment arrangements with Marion Utilities before? Were you able to keep those arrangements?
Has your water been disconnected within the last two years?
I am giving permission for the United Way of Grant County and Marion Utilities to use my story in media marketing materials for the H2O program.
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform