Apply for Rebates

Rebate Application

Instructions:

1. Complete the application below

2. Upload a copy of the receipt for the appliance purchased, with the date clearly shown and the appliance and price circled.

3. Application must be completed within 30 days of purchase.

*First Name

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*Last Name

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*Home or Cell Number

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*Email

*Was your gas appliance?

*Street Address

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*City

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*Zip Code

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*State

*Country

*Is this also your mailing address?

Yes

If no, please enter mailing address below

*Please select your cities gas provider:

*Please Select your Gas Appliance

*Serial Number

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*Date Purchased

Certification of Purchase and Installation:

*By checking this box, applicant certifies that the appliance above was purchased and installed at the applicant’s residence.

*How did you hear about us?

Other