Window and Insulation Incentive Form

Select Basement TypeNoneCrawlspaceCrawlspace with Vapor BarrierFull BasementGarage/Basement ComboHalf BasementSlab-on-GradeOther

Select Primary Heating SystemDucted Heat PumpDuctless Heat PumpElectric BaseboardElectric FurnaceGas BoilerGas FireplaceGas FurnaceOil HeaterPropane HeaterWood Fireplace

Select Secondary Heating SystemDucted Heat PumpDuctless Heat PumpElectric BaseboardElectric FurnaceGas BoilerGas FireplaceGas FurnaceOil HeaterPropane HeaterWood Fireplace

Select Water HeatingElectric Standard TankElectric TanklessGas Standard TankGas TanklessHeat Pump Water HeaterOther: ElectricOther: GasPropane

Is it a rental property? YesNo

Please sign below:

Your electronic signature agrees to these terms and conditions and authorizes H.E.L.P. Group INC to submit an application and all required invoices or measure documentation to Energy Trust on Customer's behalf. By that authorization, Customer represents to Energy Trust that all measures have been completed satisfactorily as of the signature date below, and that any accompanying invoices or measure documentation are complete and accurate. If your incentive application meets energy Trust requirements, the cash incentive will be paid to you within 4-6 weeks of receipt of the application.

If you would rather complete this agreement manually and send it back to us, please check below this box