Registered Dealer Application

Clean Energy Credit Union Registered Dealer Application

Please complete the questions below to be considered for our Registered Dealer program. Once you have submitted this form, we will begin our review and follow up with next steps.

Registered Dealer Application

Company Information

please list your company’s legal name as filed with your Secretary of State
Main Office Address(Required)
(Cooperative, C-Corp, B-Corp, S-Corp, LLC, Partnership, Sole Proprietorship, Other – Please Explain)
MM slash DD slash YYYY
Example programs: NYSERDA, Maryland Clean Energy Advantage, Montgomery County Green Bank, Bloomington Green Home Improvement, Etc.
Examples: battery storage, EV chargers, geothermal systems, air/ground source heat pumps, roofing, insulation, windows, Etc.
Examples: referrals, canvassing, call center, leads provider, internet ads, other – please explain
please provide details
Warranty must be provided by your company and cannot be a manufacturer’s warranty or insurance policy

Primary Points of Contact & Employee Information

Primary Point of Contact(Required)
Secondary Point of Contact(Required)