CALIFORNIA WATER GUARD
Residential Efficiency Program Application
Primary Applicant
Personal Information
Full Name
Date of Birth
Email Address
Primary Phone
Secondary Phone
Residence Details
Street Address
Zip Code
Social Security Number
Residence Type
Select...
Homeowner
Renter
Monthly Mortgage/Rent ($)
Time at Residence
Employment & Income
Employment Status
Select...
Employed
Self-Employed
Unemployed
Retired
Employer Name
Occupation Title
Gross Monthly Income ($)
Co-Applicant Information
Personal Information
Full Name
Date of Birth
Email Address
Primary Phone
Co- Applicant Social Security Number
Secondary Phone
Residence Details
Street Address
Zip Code
Residence Type
Select...
Homeowner
Renter
Monthly Mortgage/Rent ($)
Time at Residence
Employment & Income
Employment Status
Select...
Employed
Self-Employed
Unemployed
Retired
Employer Name
Occupation Title
Gross Monthly Income ($)
Final Details
Notes / Water Issues
Submit Application