EmailThis 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 RequirementsConsent(Required) Your home’s primary heating source is electric.(Required)Consent(Required) Must be a single-family, multi-family or manufactured home.(Required)Consent(Required) New construction homes are not eligible.(Required)Consent(Required) Pre-existing windows or patio doors must be either single- or double-paned. Pre-existing triple-paned windows or patio doors are not eligible.(Required)Consent(Required) Replacement windows must have a U-factor of 0.30 or lower.(Required)Consent(Required) Replacement patio doors must have a U-factor of 0.35 or lower.(Required)Consent(Required) Rebates are not available for replacement windows or patio doors outside the electrically heated area (e.g., garages and workshops), or in any space with an overhead door.(Required)Consent(Required) Upon completion submit copy of one NFRC sticker per window or the manufacturer’s window order confirmation with U-factor.(Required)Consent(Required) The final invoice including the quantities and window measurements of each new window, the total cost (including labor) and purchase or installation date. Estimates, proposals or quotes are not accepted as the final invoice.(Required)Rebates will be credited to members’ account unless otherwise noted.Applicant’s Electronic Signature (Full Name)(Required)
