Become an Authorized Energy Partner Energy Partner ApplicationPlease enable JavaScript in your browser to complete this form.How are you interested in partnering with 买球365? *Commercial BrokerTelemarketing (call center)Door to Door VendorReferral PartnerIndirect SalesAffinity SalesWeb Brokercheck that applyHow are you interested in working with 买球365 retail business? *AggregatorAggregatorBrokerConsultantselect all that applies First Name *Last Name *Title *Company/Organization Name *State of Incorporation *Where is your business registered? *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWebsite(if applicable)Email *Phone *Street Address *City *Zip Code *State *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingHow many years has your company/organization been in business? *1-23-56-910+What products/services are you interested in? *Electricity Natural GasRenewable Energy How large is your member/customer base? *0-5051-250251-10001001-50005000+How would you describe your customer base? Do you target any specific verticals or customer types? *Average size of the customer - Electric (Average Annual Usage KWH) Residential and Small Business <50,000 KWHCommercial and Industrial >50,000 KWH(Select one)Average size of the customer -Gas (Annual Usage Therms) Residential 45DTH and below Small Business 5,000 DTH and belowCommercial 2,500 to 30,000 DTHIndustrial <30,000 DTH(Select one)What states are you currently active in? *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingIn the states mentioned above, which ones do you have a license? *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDownload the files here background/credit check, W-9 form, and the ACH authorization payment form. File Upload Click or drag files to this area to upload. You can upload up to 3 files. You can upload the files here Submit
