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HES Lobby Closing Thursday, March 28th for Renovations

Beginning Thursday, March 28th, the HES lobby will be closed for renovation. The HES drive thru will remain open...... Read More »
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Lifeline Form

The National Verifier, not HES/energynet, determines your eligibility to receive Lifeline benefits. If you do not currently receive the Lifeline discount through the National Verifier, please visit www.affordableconnectivity.gov to apply. Only persons who have been determined to be eligible for Lifeline by the National Verifier should complete the Enrollment Form below.

This signed Lifeline Enrollment Form is required to enroll you in HES/energynet’s Lifeline Program. The information you enter on this Enrollment Form must be exactly the same as what you provided the National Verifier to receive eligibility approval, which expires after 45 days. Submitting this form does not guarantee an immediate Lifeline discount with HES/energynet.

Lifeline Enrollment Form

  • Date Format: MM slash DD slash YYYY
  • RESIDENTIAL ADDRESS

    Must be a street address (not a P.O. Box) and your principle residence
  • QUALIFICATIONS THROUGH DEPENDENT

    Complete if you qualified in the National Verifier through a child or dependent in your household.
  • Date Format: MM slash DD slash YYYY
  • CERTIFICATIONS

  • LIFELINE NOTICES AND DISCLOSURES

  • APPLICANT SIGNATURE

    By my electronic signature below, I certify that the information provided above is true and correct, and agree to the above Certifications. I further certify that I have read and understand the above Notices and Disclosures of this Enrollment Form.
  • Date Format: MM slash DD slash YYYY