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Date of your desired service
Floor or Apt.
Billing Address (if different from above)
Please circle one
RentalPurchasing HomeBuilding Home
Owner of the property
Owner Phone Number
Have you previously been a WMGLD customer?
If yes, year
Previous tenant (if known)
Electric HeatGas HeatOther
Are you interested in the direct payment plan?
Does this house have solar?
If "Yes," please go to our INTERCONNECTION APPLICATION page after you submit this application.