Low Income auto repair

Low Income Auto Repair Application

[contact-form to="[email protected]" subject="Low Income Application"][contact-field label="Full Legal Name" type="name" required="1"][contact-field label="Email" type="email" required="1"][contact-field label="Phone Number" type="text" required="1"][contact-field label="Residence address: Street/City/State/Zip/Country" type="text" required="1"][contact-field label="Number of dependents: (spouse, children, step children, adopted)" type="text" required="1"][contact-field label="Are you currently on any state assistance:" type="text" required="1"][contact-field label="Are you currently employed? If so please list your employers contact information:" type="text" required="1"][contact-field label="Your monthly household income:" type="text" required="1"][contact-field label="Please list the type of insurance each vehicle has: Full Coverage / PLPD / None" type="text" required="1"][contact-field label="Which vehicle listed is your main vehicle: (vehicle that takes you to work)" type="text" required="1"][contact-field label="Please tell us why you need to apply for the Low Income Auto Repair Program:" type="text" required="1"][contact-field label="Your full date of birth month/day/year:" type="text" required="1"][contact-field label="If a vehicle is not running, do you have a way transport it to a qualified Low Income Auto Repair facility?" type="text" required="1"][contact-field label="Please List the make/model/year/engine size/Lic plate# of the vehicles you wish to enroll in the program: also please specify: Own/Lease/Payments" type="textarea" required="1"][contact-field label="Are the vehicles your applying to be enrolled, in good running condition, if not what is wrong with them:" type="textarea" required="1"][contact-field label="I confirm that the information given in this form is true, complete and accurate." type="checkbox" required="1"][contact-field label="Verify Email" type="email" required="1"][contact-field label="I understand when submitting this application it will not redirect me to a application completed page. Once I press Submit the application has been submitted. I will not submit this application twice." type="checkbox" required="1"][/contact-form]

LOW INCOME AUTO REPAIR

We are a proud service provider of Michigan's First Low Income Auto Repair Program. The Low Income Auto Repair Program is here to help individuals & families with low income, maintain the mobility they need to stay working in Michigan.

Our Foundation was build on one goal, to get & keep Michigan Working! Our foundation has blessed to have the support of many Local business helping to provide Low income families & individuals a low cost solution to car maintenance and repairs. If you feel your family qualifies for the Low Income Auto Repair Assistance, you must first fill out an application. Then mail, deliver, or email the application to us and wait for a response, it's that simple!

If you need an application, you can request one by email, phone, fill out an application online, or stop by to pick one up. The application email is [email protected] Please be patient with us, our wait time varies month to month depending on the amount of applications we've accepted.
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