Country Energy - Sign UP CountryGreen

Domestic
Business

Customer number:

Title:

First Name:

Middle Name:

Last Name:

If a residential customer, please enter:

Date of birth:

e.g.23/02/1989 (dd/mm/yyyy)

Driver's licence number:

Or a password you nominate.

If a business customer, please enter:

Trading name:

ABN:

Phone number:

Email:

Preferred method of contact:

For residential:

Product *	Price (incl. GST)	Accreditation	GreenPower kWh's	Please select
foreverGREEN	$6.00 extra per week	100%	6,470 kWh's	Yes
livingGREEN	$3.85 extra per week	50%	3,235 kWh's	Yes
liteGREEN	$1.85 extra per week	20%	1,294 kwh	Yes
everydayGREEN	$1.00 extra per week	10%	647 kWh's	Yes

* Based on 6,470kWh's per annum, which is indicative of the average household electricity consumption as determined by the Department of Water and Energy. Prices are subject to review and may vary from time to time.

For business:

Product *	Price (incl. GST)	Accreditation	GreenPower kWh's	Please select
countrygreen® energy - business	Additional 1.1 cent per kWh	10%	Consumption based	Yes
businessADVANTAGE	Additional 5.5 cent per kWh	100%	Consumption based	Yes

* Consumption based product.

By signing up to the product of your choice, the respective amount of renewable energy shown in the table above will be purchased on your behalf.

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Select customer type

Your details

Customer number:

Title:

First Name:

Middle Name:

Last Name:

Proof of identity

If a residential customer, please enter:

Date of birth:

Driver's licence number:

If a business customer, please enter:

Trading name:

ABN:

Contact details?

Phone number:

Email:

Preferred method of contact:

Please select a product that suits you needs and budget:

For residential:

* Based on 6,470kWh's per annum, which is indicative of the average household electricity consumption as determined by the Department of Water and Energy. Prices are subject to review and may vary from time to time.

For business:

* Consumption based product.

By signing up to the product of your choice, the respective amount of renewable energy shown in the table above will be purchased on your behalf.

Any comments/questions about countrygreen®?

Select customer type

Your details

Customer number:

Title:

First Name:

Middle Name:

Last Name:

Proof of identity

If a residential customer, please enter:

Date of birth:

Driver's licence number:

If a business customer, please enter:

Trading name:

ABN:

Contact details?

Phone number:

Email:

Preferred method of contact:

Please select a product that suits you needs and budget:

For residential:

* Based on 6,470kWh's per annum, which is indicative of the average household electricity consumption as determined by the Department of Water and Energy. Prices are subject to review and may vary from time to time.

For business:

* Consumption based product.By signing up to the product of your choice, the respective amount of renewable energy shown in the table above will be purchased on your behalf.

Any comments/questions about countrygreen®?

* Consumption based product.

By signing up to the product of your choice, the respective amount of renewable energy shown in the table above will be purchased on your behalf.