RARA Utilities Assistance Form

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Please fill out this form to start a request for help with a utility bill. We are only able to assist residents of Rockbridge County, and bills must be past due. Someone from RARA will call you within 2 business days to complete the full application.

Requests may also be made by phone at (540) 463-6642. Phone applications are accepted Monday-Thursday 9:30am-12pm. We can only help with 1 type of request at time, so please decide if you would prefer housing support or utilities assistance before filling out the application.

If you need food assistance, the Neighborhood Grocery is open Monday/Wednesday/Thursday from 2:30-4:30pm and Saturday from 10am-12pm. You may also schedule a pick-up order at another time at www.raralex.org.

First and Last Name *

Phone Number *

Email Address

Have you received assistance from RARA before? *

Yes

I don't know

Which utility do you need help with? *

Electricity

Water

Heating Fuel

Required

Name of Company *

Dominion (DVAP)

BARC

Columbia Gas

Buena Vista Water

Lexington Water

Glasgow Water

Goshen Water

Rockbridge County Water

Other:

Required

Are you at least 1 month behind on your bill? *

Bills must be past due for us to assist.

Yes

I don't know

Is there any time you are NOT available for us to call back? The application process usually takes about 10 minutes.

Do you prefer speaking to someone in Spanish? / ¿Prefiere hablar con alguien en español?

Yes / Sí

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