EnviroWatts

Enrollment Form

Yes, I want to help make a difference. I want to enroll in the Parke County REMC EnviroWatts Program, and support the research and use of renewable energy.

I agree to pay the extra charge of $1.00 per 100-kilowatt hours of electricity on my monthly electric bill as indicated below.

In order to keep administrative costs to a minimum, we ask that you commit to the program for one year. If you have any problems, send an email to ckilby@pcremc.com or call 800.537.3913.

Full Name:

Service Address:

City:
, IN

Zip:

Daytime Phone:

Email address:

Enter your account number(s), up to five.
If you have more than five,
please call our office to signup at 800.537.3913.
Account Numbers are not required,
but are encouraged for accuracy.

Account Number:

Account Number 2:

Account Number 3:

Account Number 4:

Account Number 5:

I hereby apply for and agree to take Enviro-Watts™ electricity service for a minimum of twelve months from the date hereof and shall continue thereafter until Parke County REMC receives at least 30-days written request to discontinue participation in this program.

I acknowledge that submitting this form constitutes my signature and agreement to the terms of the program.