Phase Change Shields

Warranty Registration

To be filled out by a certified technician.

Make sure you get the kWh and Therms information from the homeowner.

First Name *

Last Name *

Street Address *

City

State

Country

Postal code

Email *

Phone *

Installation Date *

Installer Number *

Technician Name *

Electricity Consumption Readings - Previous 12 months

Month #1 kWh *

Month #2 kWh *

Month #3 kWh *

Month #4 kWh *

Month #5 kWh *

Month #6 kWh *

Month #7 kWh *

Month #8 kWh *

Month #9 kWh *

Month #10 kWh *

Month #11 kWh *

Month #12 kWh *

Gas Consumption Readings - Previous 12 months

if the homeowner heats with electricity please put the number zero (0) in each field. No fields can be left empty.

Therms Month #1 *

Therms Month #2 *

Therms Month #3 *

Therms Month #4 *

Therms Month #5 *

Therms Month #6 *

Therms Month #7

Therms Month #8 *

Therms Month #9 *

Therms Month #10 *

Therms Month #11 *

Therms Month #12 *

Installation Pictures - Minimum of 3 *

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.