ChargeWise Program Enrollment

First

Last

Service Address

City/Town

ZIP/Postal Code

Phone

SWCE Account Number

Electric Vehicle Information

Make

Model

Year

VIN Number

License Plate #

Purchase Date

Contractor Information

Name

Company

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Date

Signature

By signing this application, I certify the electric vehicle I am enrolling in the ChargeWise program is installed at the address listed above, and that I am a SWCE member.

Photo

Upload charger photo

One file only.
9 MB limit.
Allowed types: gif, jpg, jpeg, png.

Receipt

Upload receipt photo

One file only.
9 MB limit.
Allowed types: gif, jpg, jpeg, png.

In the event of an emergency: Please do not use email to contact SWCE. We cannot guarantee messages received via email will be monitored during an outage.