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ENERGY ASSISTANCE PROGRAMS

Section One: Application Process Intake, Operations & Policy Manual

Program Year 2026 12 ALL DEMOGRAPHIC DATA MUST BE REQUESTED FOR EACH HOUSEHOLD MEMBER— (However, services will not be denied for refusal to provide demographic information) 9. Language: Enter the applicable language acronym for each household member. 10. Gender: Enter gender code. 11. Ethnicity: Enter ethnicity code. 12. Race: Enter the applicable race acronym for each household member. 13. Oregon Tribes: Enter Oregon Tribes code. 14. Education: Enter the acronym of the highest level of education completed for all Household Members. 15. Disability: Enter disability code. 16. Veteran: Enter veteran code. 17. Homebound: Enter homebound code. 18. Non-Cash Benefits: Enter the non-cash benefit(s) code, select all non-cash benefits that apply. 19. Phone: Enter a primary telephone number for the household. When available enter secondary phone number(s). 20. Mailing Address: Enter the household’s mailing address. 21. Physical Address: Document the household’s physical address. (Please note if different from the mailing address) The physical address on the application must match the service address on the utility bill/vendor receipt. If physical address is not on standardized utility bill, vendor receipt or landlord letter, alternate documentation of physical address must be provided. If a client is unable to provide documentation with their physical address due to living in non-structured housing, a “proof of residency/physical address” form must be completed by the client. 22. Dwelling Type: Circle the correct dwelling type. 23. Residence Status: Circle the correct residence type. 24. Energy Sources: Circle the correct energy sources type. Under “Enter Primary Energy Source” indicate the letter beside your energy selection.