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  • Energy Savings Program

    Offered by Xcel Energy. Administered by the Energy CENTS Coalition

  • Household and Property Information

  • Please check the service(s) provided by Xcel Energy:
  • What County do you live in?*

  • STOP

    You do not live in our service territory.  We serve all of Ramsey and Washington County and a some cities in Anoka, Chisago and Dakota County.  Click on the link below to find the Agency that serves your county:

    https://mn.gov/commerce/consumers/consumer-assistance/weatherization/wap-providers.jsp

         

  • Format: (000) 000-0000.
  • Phone type

  • Format: (000) 000-0000.
  • Phone type

  • Do you Own or Rent*
  • Select the option that best describes your home:*

  • Income Information

  • Income Sources (Check all that apply)*

  • Enter total MONTHLY Gross Wages for all household members. (We do not include wages for K-12 students)*
  • Enter total MONTHLY Net income from Social Security benefits for all household members: (SSA/SSDI/RSDI,SSDI)*
  • Enter total MONTHLY Net income from Supplemental Security benefits (SSI) for all household members: *
  • Enter total MONTHLY income from MFIP (Minnesota Family Investment Program) for all household members: *
  • Enter total MONTHLY income from General Assistance for all household members: *
  • Enter total MONTHLY income from Diversionary Work Program for all household members: *
  • Enter total MONTHLY income from Veterans' Benefits for all household members: *
  • Enter total MONTHLY Gross income from Workers' Compensation for all household members: *
  • Enter total MONTHLY Gross income from Unemployment Compensation for all household members: *
  • Enter total MONTHLY Gross income from Retirement Income (Not Social Security) for all household members: *
  • Enter total MONTHLY Gross income from Pension (Not Social Security) for all household members: *
  • Enter total MONTHLY Gross income from Long Term or Short Term Disability for all household members: *
  • Enter total MONTHLY Gross income from Alimony or Spousal Support for all household members: *
  • Enter total MONTHLY Gross income from Ongoing support from family or friends for all household members: *
  • Self Employment: Add lines 3 + 4 + 5 and 6 on your 2025 IRS 1040 Schedule 1 - tax form. If you did not file as self employed on your last return or if you did not file a return, enter your estimated net income from self employment for the year (Annually)*
  • Please enter what your "other income" is in the space provided above, and enter total MONTHLY Gross income from that income source.*
  • Did you receive a grant from the Low Income Home Energy Assistance Program (LIHEAP) in the last 12 months?*
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  • Heating and Appliance Information

  • Have you had a Home Energy Squad Visit?
  • If Yes, Date of Visit
     - -
    2 digit month, 2 digit day, 4 digit year
  • Have you had any insulation added to your home in the past 10 years?
  • If yes, was the insulation installed by Community Action Partnership?
  • Check the electric appliance(s) that you own and are interested in replacing:*
  • Check the heating appliance(s) you own: (Heating appliance must be natural gas)*
  • How did you hear about us?

  • Terms and Conditions

  • By signing this document, I am signing up for the Energy Savings Program.  I also agree to allow the Energy CENTS Coalition to obtain information from Xcel Energy and from other heating utility accounts and share that information with other organizations that provide energy conservation and other relevant services.  I verify that all information on this application is, to the best of my knowledge, correct. 

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: