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Renewable Energy Program Sign Up Form

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First Name*
Last Name*
Address1*
Address2
City*
State*
Zip*
Phone*
Email
Account Number (If Available)
The total number of blocks you wish to have on your account:
1. 1 block (300 kWh) at $2
2. 2 blocks (600 kWh) at $4
3. 3 blocks (900 kWh) at $6
1. 4 blocks (1200 kWh) at $8
2. Another number of blocks (specify number below)
Please specify the number of blocks you wish to purchase:

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1. Receive an email copy of this form.
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Renewable Energy Program Sign Up Form

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