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2024-2025 Energy Pledge - Energy Assistance Agencies

Please fill out this commitment with recipient only after going through Education Worksheet.
1.First Name(Required.)
2.Last Name(Required.)
3.Is this participant an Xcel customer?(Required.)
4.Preferred Language
5.Zip Code
6.Which One Time Action will you take to lower your gas or electric bill? (If appointment is in-person, have them write these actions on their magnet)
7.Which Everyday Action will you take to lower your gas or electric bill? (If appointment is in-person, have them write these actions on their magnet)
8.Do you commit to checking your energy use each month to understand how your actions are affecting your gas or electric bills?
9.How do you typically view your energy bill?
10.Was this appointment...
11.Energy Outreach Colorado (the non-profit that funds this program) would like to reach out to you to offer additional tools, support and seasonal reminders. Please provide e-mail address and mobile number that receives texts (if any). Provide mailing address for those without email or mobile phone.
12.Additional comments from appointment
13.Organization Performing Education(Required.)