Flex Peak Application Fields marked with * are required Form Errors Please correct the following errors and resubmit. Customer Information Company Name (Organization’s Legal Name) * Mailing Address * City * State * Select ID OR ZIP Code * Phone (e.g., 2085551212) * Incentive Payment Information Legal Business Name * Please enter the Last Four Digits of Your Federal Tax ID # (EIN or SSN). For example, XX-XXX1234 or XXX-XX-1234 * Use Customer Mailing Address as Payment Mailing Address Mailing Address * City * State * Select ID OR ZIP Code * Payment Option at End of Season Please select your end of season payment option Mail Check Bill Credit * Please specify your Account Number * Facility Site Information Authorized Contact Name * Title * I want to be notified via text message (msg & data rates may apply) Business Phone (e.g., 2085551212) * Cell Phone (e.g., 2085551212) * Cell Phone (e.g., 2085551212) Email Address * Confirm Email Address * List of Sites List the Facility Site(s) you wish to enroll below. If you prefer the "Aggregated Option", specify which site(s) you want combined. Site #1 Auto or Manual Dispatch Option Auto Manual * Aggregated Option Yes No N/A * Meter Number * Nominated kW Amount * Facility Site Location/Address * I would like to add more Facility Sites Site #2 Auto or Manual Dispatch Option Auto Manual * Aggregated Option Yes No N/A * Meter Number * Nominated kW Amount * Facility Site Location/Address * Site #3 Auto or Manual Dispatch Option Auto Manual Aggregated Option Yes No N/A Meter Number Nominated kW Amount Facility Site Location/Address Site #4 Auto or Manual Dispatch Option Auto Manual Aggregated Option Yes No N/A Meter Number Nominated kW Amount Facility Site Location/Address Site #5 Auto or Manual Dispatch Option Auto Manual Aggregated Option Yes No N/A Meter Number Nominated kW Amount Facility Site Location/Address I would like to add even more Facility Sites Site #6 Auto or Manual Dispatch Option Auto Manual * Aggregated Option Yes No N/A * Meter Number * Nominated kW Amount * Facility Site Location/Address * Site #7 Auto or Manual Dispatch Option Auto Manual Aggregated Option Yes No N/A Meter Number Nominated kW Amount Facility Site Location/Address Site #8 Auto or Manual Dispatch Option Auto Manual Aggregated Option Yes No N/A Meter Number Nominated kW Amount Facility Site Location/Address Site #9 Auto or Manual Dispatch Option Auto Manual Aggregated Option Yes No N/A Meter Number Nominated kW Amount Facility Site Location/Address Site #10 Auto or Manual Dispatch Option Auto Manual Aggregated Option Yes No N/A Meter Number Nominated kW Amount Facility Site Location/Address Additional Contacts for Event Notification List any additional contacts you wish to enroll below. I would like to add additional contacts Additional Contact #1 Name * Title * Receive text message notifications? (msg & data rates may apply) Business Phone (e.g., 2085551212) Cell Phone (e.g., 2085551212) * Cell Phone (e.g., 2085551212) Email Address * Additional Contact #2 Name Title Receive text message notifications? (msg & data rates may apply) Business Phone (e.g., 2085551212) Cell Phone (e.g., 2085551212) * Cell Phone (e.g., 2085551212) Email Address Additional Contact #3 Name Title Receive text message notifications? (msg & data rates may apply) Business Phone (e.g., 2085551212) Cell Phone (e.g., 2085551212) * Cell Phone (e.g., 2085551212) Email Address Additional Contact #4 Name Title Receive text message notifications? (msg & data rates may apply) Business Phone (e.g., 2085551212) Cell Phone (e.g., 2085551212) * Cell Phone (e.g., 2085551212) Email Address Additional Contact #5 Name Title Receive text message notifications? (msg & data rates may apply) Business Phone (e.g., 2085551212) Cell Phone (e.g., 2085551212) * Cell Phone (e.g., 2085551212) Email Address How did you learn about the Flex Peak Program? Customer Service Representative Brochure in mail Newsletter Email Social Post Digital Ad Paid Search Referred by colleagues Customer Agreement By typing your name in the box, you are electronically signing the application, subject to the ‘Customer Agreement . Customer Signature * Date (mm/dd/yyyy) * Form Submitted Submit Form
