Tell Your Story Name First Last City and State City State / Province / Region Email Phone NumberPlease tell us about the impact that the LIHEAP program has had on your ability to sustain yourself and your household.If LIHEAP was de-funded and not available for you, what would you have to sacrifice in order to pay for your gas and electric costs?Select one of the following:I give LIHEAP Helps California permission to share my storyI give LIHEAP Helps California permission to share my story - I would like my personal information to remain confidential
