CLEAN POWER PROGRAM REBATE APPLICATION 1. Only one rebate per member 2. Rebate is $500 per system with a minimum system size of 2kW 3. Must be a CLEAN Power Program contributor 4. Must provide a project invoice or amounts paid for materials and labor 5. Application deadline is within 3 months of net metered connection to MPE's system Type of Rebate Residential Business/Commercial Applicant Info Applicant Name First Name Last Name Name on Electric Account, if Different Mailing Address Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Phone Email Contact Person Renewable Energy System Info Installation Address Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code More Enter physical location of renewable energy system Nameplate Capacity Attach a final invoice that includes the for the project's total installation cost. Upload Upload requirementsOne file only.100 MB limit.Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. List all other sources of funding for the project By accepting this grant you agree to allow MPE to photograph and publicize your installation. Yes No List all energy efficiency measures that you have adopted at this location prior to installation of your renewable system. For what reason(s) did you install your renewable energy system? Please provide the name & contact information for your installer. Date your system became operational. Clean Power Info Are you currently a Clean Power Program contributor, purchasing $1 blocks from MPE? (NOTE: To qualify for a rebate, you must contribute. If you are not yet a contributor, please fill out and submit the CLEAN POWER CONTRIBUTION FORM or call MPE). Yes No How many blocks? Have you received a clean power rebate from MPE before? Yes No Status message Rebate Application Processing Rebates will be considered upon completion of interconnection of your renewable energy system. Upon emailing this form, the applicant warrants and represents that the information provided is true and complete until a written notice of change is provided. The applicant also agrees that the Mountain Parks Electric Clean Power Committee is authorized to make inquires deemed necessary to validate the rebate application's accuracy. All information included in your rebate application will be used for the sole purpose of determining whether or not to award the project rebate dollars. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit