Energy savvy families interest form

Please complete this form to nominate someone for the Energy Savvy Families program.

Nominees must be the Ergon Retail account holder at that address.

View our privacy policy.

Required fields are marked with an asterisk (*).

Customer details
Date of Birth
Your account number is in the top right section of your electricity bill.
Please enter as a 10 digit number with no spaces e.g. 0404111222
Your details

Privacy notice

Ergon Energy is collecting personal information on this form for the purpose of registering interest in the Energy Savvy Families program. This collection is protected under the Privacy Act 1988 (Cth). Personal information submitted through this form will be shared with program partners and organisations involved in delivering the Reduce Your Juice and HomeSmart components. If you do not provide all of the personal information requested we may not be able to assess your request. If you wish to obtain access to your personal information held by Ergon Energy or make a privacy complaint, please refer to our Privacy Policy, or contact our Privacy Officer at

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