Enroll in the program(s) of your choosingName(Required) First Last Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone(Required)Mobile Provider(Required) Email(Required) Consent(Required)I am volunteering for the PowerShift program(s) listed below, to assist my cooperative in reducing the consumption of electricity during the peak summer months. By signing this form, I am authorizing Kankakee Valley REMC to enroll me in the program(s) as indicated below. I can, at any time, opt out of the program(s) or change the method of contact. I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Enroll in(Required)Water heater must be electric to qualify. Please call the office to schedule an appointment to have a water heater switch installed. Beat the Peak Powershift AC Switch Powershift Water heater Switch When a peak occurs, contact me by(Required) Email Text Member Electronic Signature (Full Name)(Required) NameThis field is for validation purposes and should be left unchanged.