Rebates Form 2021 At The Energy Cooperative, we are committed to helping our members save energy and money through our appliance rebate program. If you are a natural gas or propane member who is NOT provided electric by The Energy Cooperative, we suggest you contact your local electric provider to inquire about possible rebate programs. Application Date* Date Format: MM slash DD slash YYYY Contact InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Enter Email Confirm Email Account Number*You can find your account number on your Energy Cooperative bill. You can also find it by logging into our website, or checking the registered accounts section in the SmartHub app. Questions? Give us a call at 1-800-255-6815 for assistance.Select RebateResidential RebatesSelect the type of rebate.Dual Fuel Heat Pump RebateGeothermal RebateElectric Water Heater RebateEnergy Star Appliance RebateRebate to add Radio Control Switch to Existing Air Conditioning UnitElectric Vehicle Charger RebateRequired InformationPurchase Date* Date Format: MM slash DD slash YYYY Where did you purchase the appliance?*Appliance*Energy Star RefrigeratorEnergy Star Stand Alone FreezerManufacturer*Appliance Model*Was the old appliance removed from the service address?* Yes No You must remove the old appliance from the service address to qualify for this rebate.Tank Size (in gallons)*Size (Tons)*EER*EER is the energy efficiency of your air conditioner. To find EER from these two variables, simply divide Capacity (BTUs) by Power (W). Both metrics will be listed on your HVAC device. You can find this information by looking up your product on the Energy Star Website. https://www.energystar.gov/productfinder/SEER*SEER, or Seasonal Energy Efficiency Rating, measures an air conditioner’s efficiency throughout an entire cooling season, with temperatures ranging from 65°F to 104°F. You can find this information by looking up your product on the Energy Star Website. https://www.energystar.gov/productfinder/HSPF*HSPF, or Heating Seasonal Performance Factor, is the measure of a heat pump's overall energy efficiency during the heating season (fall and winter). You can find this information by looking up your product on the Energy Star Website. https://www.energystar.gov/productfinder/Heating Backup* Fuel Oil Natural Gas Propane Electric Other Water Heating Option* Supplemental On Demand Not Applicable Loop Type* Horizontal Vertical Pond Open Well Pump and Dump Closed or Open Loop?* Closed Loop Open Loop Size of elements (in watts)*Type of Water Heater* Standard Heat Pump Efficiency*What type of system did you replace?* The system is in a new home. Geothermal Heat Pump Dual Fuel Propane Natural Gas Fuel Oil Other Electric Are you interested in a Radio Control Switch?* Yes No We have existing switch. Ductless Mini-Split System Type* Single Zone Multi-Zone Central System Type* Split System Single Package System Interested in a cool returns rebate?* Yes No Number of Charging Ports*Model Number*Questions/ Comments?Documentation* Drop files here or Please upload pictures or scans of receipts, proof of delivery or installation, and any other requirements for the program. CommentsThis field is for validation purposes and should be left unchanged.