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Customer Information

*Required Fields

Company Name*

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First Name*

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Last Name*

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Title*

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Email*

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Confirm Email*

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Phone Number*

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Your bullfrogpowered Location

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Address*

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Suite/Unit

City*

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Province*

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Postal Code*

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Same address for billing?

Billing Address

Address*

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Suite/Unit

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City*

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Province*

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Postal Code*

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How did you hear about us?*

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Comments

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Promocode

Note: only one promo code per product can be applied.

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Payment Details

You will be invoiced $ plus applicable taxes monthly for your green electricity from Bullfrog Power, starting one month from today’s date. This bill is in addition to your existing bill for electricity.

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Pre-Authorized Credit Card

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Card Number

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Expiry Month

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I hereby authorize bullfrog power to charge my credit card.

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Cheque

Upon receipt of your monthly invoice, please make your cheque payable to Bullfrog Power Inc. and mail it to:

Bullfrog Power Inc.
30 St Patrick St, Suite 600
Toronto, ON M5T 3A3

Please read the Bullfrog Power legal agreement here.
By clicking the box below, you confirm that you have read and understood the terms of the agreement.

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