Enroll or Recertify

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To enroll or recertify, please choose one of the methods below:

Enroll using My Energy
Login, then click 'Financial Assistance' in the left menu
Or, complete this one page form, and click 'Submit' to accept the Declaration.

Bold Fields Required

Customer/Household Information

Account Number(First 10 digits only. Format: 1234567891)

How to find your account number

Customer NameService Address Street Number
Apartment
Suffix

Please enter a valid number and This field is required Please enter a valid number Street Name City State
Zip Code

Emailoptional(e.g. john@smith.com)Number of AdultsNumber of Children
Total Annual Household Income
$.00 This field is required

Please select a Household Income Source

Household Income Eligibility

Check all sources of household income. You may be enrolled in either the CARE or FERA program depending on your household size and income.

PensionsSocial SecuritySSP or SSDIInterest/Dividends from: Savings, Stocks, Bonds or Retirement AccountsWages and/or Profits from Self-EmploymentRental or Royalty IncomeUnemployment BenefitsDisability or Workers Compensation PaymentsScholarships, Grants or other aid for living expensesInsurance or Legal SettlementsSpousal or Child SupportCash and/or Other Income (Tribal Only)

Please select a Public Assistance Program

Public Assistance Program Eligibility

Check all programs you or someone in your household participate in.

Medicaid/Medi-Cal (under age 65)Medicaid/Medi-Cal (age 65 and older)Supplement Security Income (SSI)CalFresh/SNAP (Food Stamps)Low Income Home Energy Assistance Program (LIHEAP)Women, Infants and Children (WIC)Healthy Families A & BCalWORKS (TANF) or Tribal TANFNational School Lunch Program (NSLP)Bureau of Indian Affairs General AssistanceHead Start Income Eligible (Tribal Only)

If a Community Outreach Contractor (COC) assisted you with this application, please enter their COC number here.optional

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