Thank you for participating in the “Fix the Brix” initiative! Your efforts help keep our neighborhood safe and beautiful. We appreciate your commitment to maintaining our community’s historic character.

Please provide the necessary documentation to apply for the “Fix the Brix” subsidy. Ensure all required fields are filled out and all relevant documents are uploaded.

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Applicant Information

All are required fields.

First Name *

Last Name *

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / RegionAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Repair Details

Description of Repair Needed: *

Cost of Repair *

Documentation

File upload section. All four are required. Allowed image formats are Jpeg [.jpg] and Png [.png], less than 5mb each.

Photos of Area to be Repaired *

Up to 2 files in .jpg or .png format. Less than 5mb each. Required.

Photos of Completed Work *

Up to 2 files in .jpg or .png format. Less than 5mb each. Required.

Invoice *

1 File in .jpg or .png format. Less than 5mb. Required.

Proof of Payment *

1 File in .jpg or .png format. Less than 5mb. Required.

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