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

Company Name(Required)

please list your company’s legal name as filed with your Secretary of State

Trade / DBA Name

Main Office Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company Phone Number(Required)

Company Email Address(Required)

Website(Required)

Company Tax ID(Required)

Company Structure(Required)

(Cooperative, C-Corp, B-Corp, S-Corp, LLC, Partnership, Sole Proprietorship, Other – Please Explain)

In Business Under Current Ownership Since(Required)

Number of years your company has been installing solar PV systems(Required)

Do you have multiple branch locations?(Required)

Please list the states where your company operates(Required)

Is your company part of the Amicus Solar Cooperative?(Required)

Is your company affiliated with any special utility, state, or other programs?(Required)

Example programs: NYSERDA, Maryland Clean Energy Advantage, Montgomery County Green Bank, Bloomington Green Home Improvement, Etc.

In addition to solar, do you provide any other services or products?(Required)

Examples: battery storage, EV chargers, geothermal systems, air/ground source heat pumps, roofing, insulation, windows, Etc.

Average monthly sales volume over previous 12 months(Required)

What are your top 3 sources of sales?(Required)

Examples: referrals, canvassing, call center, leads provider, internet ads, other – please explain

Average number of residential projects you anticipate financing with Clean Energy Credit Union each month(Required)

Do you self-perform your installations, subcontract your installations to another company, or do both?(Required)

please provide details

How many years is your workmanship/labor/installation warranty?(Required)

Warranty must be provided by your company and cannot be a manufacturer’s warranty or insurance policy

A. Do you have working capital/revolving line of credit?(Required)

B. If yes, please list your lender

Are you willing to submit 2 years of company financials and other business formation documents?(Required)

Primary Points of Contact & Employee Information

Primary Point of Contact(Required)

First Last

Primary POC Title(Required)

Primary POC Phone(Required)

Primary POC Email(Required)

Secondary Point of Contact(Required)

First Last

Secondary POC Title(Required)

Secondary POC Phone(Required)

Secondary POC Email(Required)

Number of licensed electricians(Required)

Number of NABCEP certified installers(Required)

Total number of employees(Required)