EasyGreen Application

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Congratulations on making the decision to sign-up for EasyGreen. Just complete and submit this form to us and we'll take care of the rest.

* Indicates a mandatory field.

Your Details

Your Name*

Date of Birth*

Postal Address*

Phone (Home)*

Phone (Work)

Mobile

Email Address

Where did you hear about EasyGreen?

Account Details

Account Number*

Number* Unit Lot Street

Street Name*

Suburb/Town*

Postcode*

Your Choice

Choose the amount you would like to contribute per bill to the production of renewable energy.

$10 $20 $30 $40 $50 $60 $70 $80

Terms & Conditions

I understand that the selected EasyGreen contribution (inclusive of GST) will be added to my account and be supplied under my existing residential contract. I confirm I am the account holder and have an existing supply contract with Synergy.

When you submit this application, EasyGreen will be applied to the next bill issued.

Address:	http://www.synergy.net.au/Residential_Segment/Green_Energy/EasyGreen_Application.html
Modified:	31/01/2008

Address:

http://www.synergy.net.au/Residential_Segment/Green_Energy/EasyGreen_Application.html

Modified:

31/01/2008