Utility Services Program

The Low Income Home Energy Assistance Program (LIHEAP), Low Income Home Water Assistance Program (LIHWAP) and Energy Share strive to lessen the financial burden associated with home heating and water costs, and help with one-time heating emergencies in qualified households. Assistance from LIHEAP and LIHWAP is oftentimes the only way in which a family can afford to provide utilities in their home during 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)

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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 4th of every following month.

Make this a monthly payment?

Cover the fee associated with this online transaction?

1. Yes, I will pay an additional {transaction_fee} to cover the cost of this transaction.

Cover the fee associated with this online transaction?

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged

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.