This form must be submitted to gain approval to use the GreenPower Customer logo. You will receive an immediate response once the form is submitted.
If you would like your businesses listed on the GreenPower website you will also need to complete this form.
Please note: The information you provide will only be used to audit businesses to ensure the GreenPower logo is used by businesses purchasing GreenPower.
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*Organisation/Trading name:
('the Customer')
Registered business name if
different from trading name |
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| *Organisation Category |
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| *Contact Name: |
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| *Position/Title: |
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| *Address: |
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| *Telephone: |
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| *E-mail: |
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| Website: |
Supply your URL address so your listing on
the
GreenPower website links to your website
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| GreenPower Purchase Details |
| *Who do you get your GreenPower from: |
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| GreenPower Provider: |
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| *Your
business’s electricity retailer: |
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| Contact Name: |
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| Energy Broker (if
applicable): |
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*National Meter Identification Number (NMI):
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1st site
This is located on your electricity bill
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2nd Site:
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3rd Site:
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If you have more than three sites, please apply
direct to the GreenPower Marketing - Program
Manager to apply: (03) 8626 8706 or
GreenPower@sustainability.vic.gov.au
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*Are you on a fixed term contract with your GreenPower provider?
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| *GreenPower Contract Term: |
To:
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| *Annual Electricity Consumption: |
Your electricity consumption is location on your
electricity bill
where your quarterly usage is
recorded usually in kWh
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| *GreenPower Consumption: |
% of Total
PLEASE NOTE: Only businesses buying 10% or more GreenPower
are eligible to use the GreenPower logo.
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*Terms and conditions |
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Please note:
By accepting the terms and conditions above you agree to suppy evidence of your
GreenPower purchase and electricity consumption details if requested by the
GreenPower Program Manager for auditing purposes.
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Please enter the characters as you see above, ignoring the lines.
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