Potomac Edison Building Operator Training Incentive Interest Form

Fill out this form to express interest in receiving a cash incentive of up to $1,000 for classes!

Program staff will review your information to confirm eligibility and reach out to provide more information.

For questions, please email energysaveMD@willdan.com.
1.What class(es) have you completed or are interested in completing?
A program representative will reach out for further information after you complete this form.
2.First Name(Required.)
3.Last Name(Required.)
4.Email(Required.)
5.Phone Number(Required.)
6.Company name(Required.)
7.What is your role within the company?(Required.)
8.How many years of experience do you have?(Required.)
9.Street Address of Potomac Edison Account(Required.)
10.City
11.State
12.Zip code
13.Type of building(Required.)
14.What is the square footage of the building?(Required.)
15.Primary heating fuel for the building?(Required.)
16.How did you hear about these incentives?(Required.)