AEPRebates | Enrollment

Enroll for your complimentary in-home energy assessment. After you submit this form, we will contact you to finalize your assessment date and time.

First Name *

Last Name *

Street Address *

City *

Zip Code *

Phone Number *

Email *

Account Number *

How did you hear about the program?

Promo Code

What type of dwelling is your home?

This dwelling type is not qualified for an in-home assessment.

Please take our online energy check-up to receive a free energy savings kit via mail.

Do you own or rent?

Own Rent

Is your home heated entirely from electric heat?

Yes No

Please download and complete the landlord consent form and return to address on form.

Do you feel air drafts inside your home?

Yes No Unsure

What day of week do you prefer for your assessment?

What time of day would you prefer your assessment?

Daytime Evening

I have read and agree to the privacy policy for the HomeSMART Energy Assessment Program.

* Required Fields