First ten digits of your SoCalGas account number (Help) *
Example: 0123456789
Total number of persons in household  
Mark any assistance programs you are enrolled in

Yearly household income    
Before deductions, including all members of the household
Optional: Select if you or a member of this household is disabled
First Name *
Last Name *
As it appears on bill
Street Number *
Street Modifier
Example: 1/2, 1/3
Street Direction
Example: N, E
Street Name *
Street Suffix
Example: AVE, BLVD
Apartment or Space Number
City *
Zip Code *
Contact Telephone *
Alternate Telephone
Email Address  
ReType Email Address    
How did you hear about the program *
Primary Language *
Dwelling Type *

Terms & Conditions:
I understand that I may be contacted by Southern California Gas Company or its Energy Savings Assistance Program representative. I give either permission to contact me at address or other information listed above, including a cell phone number, email, mail or telephone. I understand that I am a customer of Southern California Gas Company and I may qualify for no-cost services. I give Southern California Gas Company permission to share my information with an Energy Savings Assistance Program Contractor who will call me to provide program details and explain what services, if any, I may be provided by the program.
The Energy Savings Assistance Program (program) is funded by California utility customers and administered by Southern California Gas Company under the auspices of the California Public Utilities Commission. This program may be modified or terminated without prior notice and is provided to qualified customers on a first-come, first-served basis, until funds are no longer available. Eligibility requirements apply. Southern California Gas Company is not responsible for any goods and services selected by the customer. Customers are not obligated to purchase any additional goods or services from the contractor.