InstagramThis field is for validation purposes and should be left unchanged.Account Number(Required)Phone(Required)Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code House Type(Required) Single Family/Stick Built Manufactured Home Apartment Other Primary heat source must be electric(Required) Heat Pump Electric Forced-Air Furnace Electric Baseboard/Zonal Gas Other Please choose one of the following I am upgrading my forced air furnace to an air source heat pump. I am upgrading my forced air furnace to a variable speed air source heat pump. I am upgrading an existing air source heat pump to a variable speed air source heat pump. RequirementsConsent(Required) Submit form for rebate pre-approval.(Required)Consent(Required) An exA new heat pump installation must be installed in a home primarily heated with an electric forced air furnace. isting heat pump of any type or a gas-fueled heating source disqualifies the home for this program.(Required)Consent(Required) Upon completion submit an invoice with equipment model, installed cost, and AHRI certificate documenting a HSPF2 and SEER2 that meets or exceeds federal minimum standards.(Required)Rebates will be credited to members’ account unless otherwise noted.Applicant’s Electronic Signature (Full Name)(Required)
