Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Property address
Street address
*
City
*
Province
*
Postal code
*
Format: A1A 1A1
Are you the owner or tenant?
*
Owner
Tenant
BC Hydro account number
*
Shipping address
Do you have a different shipping address separate from the property address mentioned above?
Yes, I have a different shipping address
No, ship to the property address
Shipping street address
*
City
*
Province
*
Postal code
*
Format: A1A 1A1
Back
Next
What type of hot water heating does your home have?
*
Gas
Propane / diesel
Wood
Other
Unknown
How is your home heated?
*
Gas
Propane / diesel
Wood
Other
Unknown
Program terms and conditions
*
I agree to the energy saving kit offer terms terms and conditions and understand they form an integral part of this agreement. I have read, fully understood and agree to be bound by all terms and conditions.
Data storage consent
*
I understand that the personal information collected may be securely stored outside of Canada, and I provide my consent.
Submit
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