FY26 EmPower Massachusetts Implementation Application Form

First Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast NamePronouns
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Second Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast NamePronouns
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

Third Partner
Organization or Individual Name*
Type of Organization*

Non-profit Community-Based Entity/OrganizationOther Non-profit Entity/OrganizationFederal and/or State Recognized TribePublic entity, such as municipalities, municipal light plants, and regional planning agencyFor-Profit Entities including: clean energy installers, energy efficiency, or home performance contractors, technical or workforce training organizations, financial institutions, or other clean energy practitionersIndividualOther (Please Clarify)
Contact Person (if different than above)

First NameLast NamePronouns
Contact Email*
example@example.com
Contact Phone*
Please enter a valid phone number.

4+ Partners
If you have more than 4 or more partners. please include additional partners' information below.

	Has SDO Certification	Meets the criteria but has not completed SDO certification
Minority Business Enterprise
Women Business Enterprise
Service-Disabled Veteran Business Enterprise
Veteran Business Enterprise
Lesbian, Gay, Bisexual, and Transgender Business Enterprise
Disability-Owned Business Enterprise

	Proposed activity (e.g. funding staff time & supplies for community outreach)	Team member receiving funds for each proposed activity (e.g., the lead applicant or a specific project partner)	Funding amount
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Contact Information