Energy Services Program

The Low Income Energy Assistance Program (LIEAP), Weatherization, and Energy Share strive to lessen the financial burden associated with home heating costs, improve home-heating safety and efficiency, and help with one-time heating emergencies in qualified households. Assistance from LIEAP is oftentimes the only way in which a family can afford to heat their home during the winter. Your contribution will provide relief to vulnerable members of your community.

Thank you in advance for your generosity.

Donation Amount

1. $100
2. $50
3. $25
4. $10
5. Other

If "Other" please use "Other Amount" field.

Other Amount

$

First Name (Required)

Last Name (Required)

Email (Required)

Mailing Address (Required)

4fd92yc0ltjv

City (Required)

State (Required)

Zip Code (Required)

Credit Card Information

Cardholder Name (Required)

Credit Card # (Required)

Visa MasterCard American Express Discover

Expiration Date (Required)

Security Code (Required)

Visa®, Mastercard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Billing Zip Code (Required)

Make this a monthly payment?

1. Yes, bill my card today and on the 21st of every following month.

Make this a monthly payment?

Comments

We would like to celebrate you as one of our donors. Can we use your name, donation amount, and comments for publications? This could include for our website, social media, and print publications.

1. YES!
2. No, I would like to remain anonymous.

Your total payment will be