Enrollment

StormSentry Enrollment From

(Before signing up, see the StormSentry Terms and Conditions)

Yes, I want to enroll in the StormSentry program. I understand that SMECO will bill me $5.25 per month plus tax on my electric bill. All information on this form must be filled in.

Name(Required)

First Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Account Number(Required)

Daytime Phone(Required)

How Would You Like SMECO to Contact You?(Required)

Phone

Choice of Complementary Plug-In Surge Protector(Required)

Consent(Required)

I understand that a fee of $50 will be billed to my account if I withdraw from the program within 12 months of enrollment.

I understand that plug-in surge protectors are needed if I want to protect my computers, televisions, VCRs, DVD players, telephones, answering machines, medical equipment, stereo equipment, and microwaves.

I have read and understood the terms and limitations listed.