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Energy Affordability Program Application

Please complete the following form below.

Applicant Information
Please enter a valid value in the format of 999-999-9999
Please enter a valid value in the format of 12345-67890

Eligibility Requirements
To prove participation in one of the above programs, customers must submit an award letter or a document that includes their name or the name of their benefit qualifying person (BQP), the name of the qualifying program, and the government, Tribal entity or program administrator that issued the document. All documentation must have an issue date within the last 12 months or a future expiration date that aligns with the benefit period.
Assistance Program Information

Customer/Benefit Qualifying Person Certification and Authorization
By checking this box below I certify that the above information is correct. I allow National Grid to share and verify information in my application or documentation for this program with Third Parties. I also allow Third Parties to give National Grid, or any representatives or agencies of the federal, state, or local government, information or documentation requested about me related to this and related programs. This information will be shared to help process my application and for ongoing participation and compliance with the program.
Information that National Grid and a Third Party may share about me:
  • Information about my application, program participation, and eligibility.
  • Information and documentation about utilities, payment history, employment history, income, application status, and award information for benefits or utilities assistance.