First Name *

Last Name *

Phone *

Email *

Address

Street Address

City

State

Country

Postal code

Who is your current electric utility company? *

If you participate in any of the following programs, you should be eligible for an LMI discount. Please be prepared to submit proof of your participation in the program.

Are you on budget billing? *

Utility Bill Upload Accepted formats: photo, PDF, or screenshot. Please upload a clear copy of all pages of your bill *

Upload Proof of Government Assistance To qualify for discounted rates, please upload a document showing enrollment in a government assistance program (e.g. Medicaid, SNAP, SSDI, etc.). Accepted formats: photo, PDF, or screenshot.

Tell us how you heard about us? *

Please elaborate on your answer above.