Elizabethtown Gas Weatherization Program

Customer Information

Eligibility Information

Authorized Signature

I certify that all information provided above is correct to the best of my knowledge. I give Elizabethtown Gas and Green life Energy Solutions permission to: 1 I share information regarding my home and energy usage with all parties planning to do work on my home or evaluate my energy usage; 2) use, at no charge, any description or pictures relating to the work performed at my home; and 3) have reasonable access to my home to inspect the work performed.