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.

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* 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.

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* 2. First Name

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* 3. Last Name

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* 4. Email

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* 5. Phone Number

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* 6. Company name

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* 7. What is your role within the company?

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* 8. How many years of experience do you have?

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* 9. Street Address of Potomac Edison Account

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* 10. City

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* 11. State

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* 12. Zip code

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* 13. Type of building

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* 14. What is the square footage of the building?

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* 15. Primary heating fuel for the building?

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