CARE/FERA Programs—Enroll/Recertify

Bold Fields Required

Customer/Household Information

Account Number(Format: 1234567891-1)

Customer Name Service 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 Adults Number of Children

Please select a Public Assistance Program or Household Income Source

Public Assistance Program Eligibility

Check all programs you participate in, and click "Submit." If you do not participate in any of the programs listed below, please complete the Household Income Eligibility section.

Medi-Cal (under age 65) Medi-Cal (age 65 and over) Food Stamps TANF (AFDC) WIC Healthy Families A&B LIHEAP

Pacific Gas & Electric - PG&E

CARE/FERA Programs—Enroll/Recertify

Customer/Household Information

Public Assistance Program Eligibility

Household Income Eligibility