Applicant Information

Name(s):_____________________________________________________

Applying for Quarter 1 / 2 / 3 / 4 (circle one)

Phone Number/Email:_____________________________________________

Address of Home:________________________________________________

Year Home Was Built:______________________________________________

Description of Project:______________________________________________________

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Additional Information About Applicants or House:______________________________________________________

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Please print and mail this application to:  

Peoria Architectural Salvage

2000 SW Adams St.

Peoria, IL 61602

OR copy and paste submit via email to:

PeoriaArchSalvage@gmail.com

Required pictures can be submitted via email separately from paper forms if desired.

Questions? Call us at 309-643-4593 or email the above address.