Community Powered Revitalization (CPR) Interest Form Thank you for your interest in Community Powered Revitalization. This form helps 6 Stones gather homeowner information and understand interest in CPR. It is not an official application for the program. Official CPR applications must be filed with each participating city. Your Name(Required) First Last Your Address(Required) Street Address Address Line 2 City State 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 ZIP Code Preferred Method of Contact(Required)EmailPhoneYour Email Address(Required) Your Phone(Required)Do you own your home?(Required) Yes No Number of people in household:(Required) 1 2 3 4 5 6 7 8+ Household IncomeIncome limits change annually and are based on household size. A team member will confirm current guidelines when we contact you. Check all that apply(Required) Handicapped or living with a disability Veteran or spouse of a veteran Age 62 or older Single head of household with dependents Briefly describe your exterior home concerns:(Required)Acknowledgment(Required) I understand this form is used to gather homeowner information and interest in Community Powered Revitalization. This is not the official CPR application. Official applications must be submitted through each participating city, and a 6 Stones team member may follow up with next steps when available.