IMPORTANT! Energy Assistance applications will now be made by Phone. Schedule your appointment, then we will call you on that date/time to make your Application.
Please call us at
414-270-4653
if you do not hear from us at your scheduled time.
Please complete the Form below
Your First Name
Your Last Name
Enter your Phone Number
Is this a Mobile Cell?
Yes - Cell Phone
No - Landline
Your Zip Code
Click to Continue
YOU MUST ENTER A VALID PHONE NUMBER. We can't reach you unless you enter a valid phone number
IMPORTENT! Complete all items on this form. If you have problems completing, call
414-270-4653
for help.
CAUTION! DO NOT ENTER MORE THAN ONE Appointment on the same date.