New Customer Registration Form
My Utility Plug represents the Customer we have no affiliation or bias towards any utility company(Electric/Natural Gas). Energy Deregulation gives you the customer the right to choose your energy supplier Electric or Natural Gas you choose the plan that's best for you. Although Internet doesn't fall under Energy Deregulation we still have great Internet options for you.
Utility Type:
*
Residential
Business
Supplier/Service wanted for:
*
Utility-Electric Supplier
Utility-Natural Gas Supplier
Internet-New Service
Current Utility/Internet provider?
*
Ex. Electric, Natural Gas, Internet
Customer Details:
Full Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
Business Address/Service Address
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Contact Me By:
*
Phone
Email
Text
Utility Bill- Electric(Businesses Submit two months)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Utility Bill- Natural Gas(Businesses Submit two months)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
How did you hear about us?
*
Please Select
Social Media
Newspaper
Internet
Magazine
Other
Please Specify
*
Feedback about us:
Suggestions if any for further improvement:
Will you be willing to recommend us?
Yes
No
Maybe
Please give reference of any two people whom you feel:
Full Name
Address
Contact Number
1
2
Signature
*
Continue
Continue
Should be Empty: