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Please fill out the online form below in order to have funds held for your high efficiency heating equipment rebate incentive
  (Required Information = required information)
Please enter customer name, E-mail address and account number
Required Information First Name:
Required Information Last Name:
E-mail:
(For faster service, enter your E-mail address)
Verify E-mail:
Required Information Account Number:  XXXXXXXXXX (no dashes)
Please enter your service address
Required Information Address:
Required Information City:
Required Information State:
Required Information Postal Code:
XXXXX or XXXXX–XXXX
Describe your home
Required Information Please check one:
I am an existing natural gas heating customer
I am converting from an oil to natural gas heating system and I have a gas account number
I am converting from an oil to natural gas heating system and I do not have a gas account number
Approximate Age of Home:
Please select the Energy Efficiency Rebate(s) for the equipment to be installed

Please Note: Equipment Installed from 1/1/11 to 12/31/11 is eligible contingent upon availability of funds
Residential Energy Efficiency Rebates Incentive Amount
Hot Water Boilers
Boilers (Forced Hot Water Condensing) AFUE = 90%$800
Boilers (Forced Hot Water) AFUE = 85% $400
Steam Boilers
Boilers (Steam w/ electric ignition) AFUE = 82%$400
Furnaces
Furnace AFUE = 94% w/ ECM$480
Furnace AFUE = 92% w/ ECM$320
Furnace AFUE = 90%$160
Water Heater
Indirect Water Heater$240
Controls
Boiler Reset Controls$100
Programmable Thermostats 1$25
Programmable Thermostats 2$25
Duct Sealing and Duct Insulation
Duct Sealing and Duct Insulation$480
Anticipated Rebate Amount
 
Additional Comments:
I hereby authorize the Company to release my energy use information to Energy Efficiency Program Sponsors (EEPS) and System Benefit Charge (SBC) program administrators and/or its designee. I understand that such information will be kept confidential and used only for the purpose of determining program eligibility and energy savings.
  I have read and understand the above authorization