Form Center

By signing in or creating an account, some fields will auto-populate with your information.

COVID-19 Utility Assistance Program : Application


  1. 1. Step One
  2. 2. Step Two
  3. 3. Step Three
  • Step One

    1. Archdale logo
    2. COVID-19 Utility Assistance Program: Application
      Please read and complete this application in its entirety before certifying its accuracy and submitting.
    3. (Found on your Monthly Statement)
    4. Please enter their names and requested information below: