CA$HBACK Emergency Program Customer Information Form
Please fill out the following information:
* Required fields.
Customer Information
* Business Name
* Service Address
* City
* State
* ZIP
* Account Number
. . . . . . . . . . . . . . . . . . . . . . . . .
Curtailment Contact Information
Primary Contact
* Name
* E-mail Address
* Confirm E-mail Address
* Work Phone
Cell Phone
Secondary Contact
Name
E-mail Address
Confirm E-mail Address
Work Phone
By submitting this form you confirm participation in the CA$HBACK Emergency Program with RG&E and that you are not enrolled in another demand response program with anothercurtailment service provider.
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