REQUEST TO CHANGE
INFORMATION ON REGISTRATION

Please use the form below if you would like to confirm the information on your registration or if there has been a change in your mailing address, physical address (i.e. place where the generator would be installed), email address, phone number (so we can contact you if and when the unit is ready for installation) or name (e.g. if you recently got married and had a name change). To help us find you on our database you will need to provide the current name and certificate number on your registration. If you have registered more than one home and need to change the information on more than one of them then you will need to submit separate change requests. After typing in your new information you may send it to us by simply hitting the "Submit" button at the bottom of the form.

Note: We recommend that you provide us with your email address so we can keep you updated on ITEC's Free Electricity program.
Registrant's Name should be as follows:
Special Instructions:
Registrant's Name:
New Information (the information you would like to confirm or change on your registration)
Physical Address should be as follows:
Phone Number(s) should be as follows:
Home Phone:

Work Phone:

Other Phone:
Email Address should be as follows:
Street:

Apt No:

City:

ST/Prov:

Zip:

Country:
Mailing Address should be as follows:
Street:

Apt No:

City:

ST/Prov:

Zip:

Country:
Registration Number:
Current Information (the name and certificate number that currently appears on your registration)