Green GenerationTM Enrollment Form

To enroll in the Green Generation program and make a positive impact for generations to come, complete the below form. The Green Generation charge will be added to your monthly energy bill.

Please note: Initial 12-month enrollment term is required. The participation costs are in addition to your monthly energy charges. 

 *  Indicates a required field    
     

   
* Participation Level: (Choose one) - Need Help?  
  GreenTeam: 100% ($0.01 per kWh)
Your monthly participation costs will fluctuate as your electricity use changes.
 
  GreenBlocks: x $1.50 each =  
Enter your desired # of blocks per month to calculate your monthly participation costs.
 
  GreenBusiness: x $1.275 each =  
Enter your desired # of blocks per month to calculate your monthly participation costs.
You qualify for the discounted price shown above if you purchase 100 blocks or more.
 

   
  Account Number:
  Your account number is shown on the front of your monthly energy bill (no spaces).  
  Promotion Code:
* Authorized By:
  Your first and last name as shown on your energy bill.  
* Service Address 1:  
  Service Address 2:
* City:    
* State:
* Zip Code:
* Daytime Phone:
  Email Address:

   
* How did you hear about Green Generation?  
   
  If an organization influenced your decision to enroll in Green Generation, please list that organization here:  
   
  Comments:  
   

   
  Please take time now to review the Green Generation program Content Label.  
     
  Please take time now to review the Green Generation program Terms and Conditions.  

   
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  Please refer to the Terms and Conditions for eligibility requirements. Customers can only enroll in one option at a time. If you have questions or would like more information, please contact us at (800) 241-3368, Monday through Friday, 8 a.m. to 6 p.m. EST.  
     
  Form 742 2-2015
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