“100% Electric” Plaque Application

Is your home already 100% electric? Get it certified now!

Congratulations on being 100% electric. You’ve earned some bragging rights. Please fill out the form below and we’ll arrange to get your plaque to you. Our nifty and beautiful aluminum plaques plus certification and handling are $10-$25 on a sliding scale.

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

I certify that this property has the following all-electric systems:(Required)

Appliances (cooktop or stove plus oven, clothes dryer)

Air heating / cooling system

Water heating

Once your sign arrives, would you be willing to share a photo and a 2-3 sentence testimonial to share on social media and/or this website?(Required)

Yes

Maybe

Choose Your Donation Amount
We encourage you to pay an amount that is meaningful and affordable to you. The metal plaques cost $25. Additional donations support our program. Any amount above $25 is considered a tax-deductible donation and is greatly appreciated..

$10 - Sliding scale
$25 - Covers the cost of a metal plaque & handling
$50 - Pay it forward (you and one other person)
$100 - Pay it forward (you and two others)
Other

Once you sign up, we will contact you regarding your pick-up point.

Your Payment Amount(Required)

Credit Card(Required)

Enter card #, expiration & security code

Cardholder Name

Phone

This field is for validation purposes and should be left unchanged.