sponsorship

Please fill in a valid value for all required fields

Please ensure all values are in a proper format.

Are you sure you want to leave this form and resume later?

Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form.

You must upload one of the following file types for the selected field:

There was an error displaying the form. Please copy and paste the embed code again.

There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue.

Approval

Sponsorship Form Status*

Approved Denied Over $1,000 waiting for Jena's Approval Pending

Comments

Denied reason sent to requester

Approved amount 1: * $

Date/Time

General Ledger Account Number 1:

Department Number - GL Account Number - Account Activity Number

Route invoice for authorization to:

IE your supervisor or VP.

edit 1

Date/Time

Holy Cross Member Information

First name*

Required

Last name*

Required

Service street address*

Required. Street address only - no city or state please

HCE electric account number*

Required. Please input your 9 digit account number. This can be found on your bill or by accessing the SmartHub data portal.

Email address*

Required

Phone number*

Required. Please use this format: (123) 456-7891

Rebate checks will be mailed to billing address on file for your account. Do you prefer the check to be mailed to a different address?

Yes No

I wish to have the rebate(s) to be paid to another party?

Yes No

Complete this section only if the rebate should be issued to someone other than the account holder.

Holy Cross Member Information

First name*

Required

Last name*

Required

Service street address*

Required. Street address only - no city or state please

HCE electric account number*

Required. Please input your 9 digit account number. This can be found on your bill or by accessing the SmartHub data portal.

Email address*

Required

Phone number*

Required. Please use this format: (123) 456-7891

Rebate checks will be mailed to billing address on file for your account. Do you prefer the check to be mailed to a different address?

Yes No

I wish to have the rebate(s) to be paid to another party?

Yes No

Complete this section only if the rebate should be issued to someone other than the account holder.

Person Submitting

You can put your name or radio number

Crew

Date

Submitter's Email*

This will be used to forward you a copy of the form.