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2. AMI Pilot Program Application
   Please fill out your contact information fully. This will be used to contact you concerning the program.
   
   Failure to do so will lead to omission of your entry.
4. Name*
6. Address*
8. Phone Number*
9. Email Address*
11. Brief Explanation of Why You Want a Smart Meter*
13. Feedback*

    Periodically, you will be asked for feedback.

    1. I Agree
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15. 1. Receive an email copy of this form.
16. Email address

    This field is not part of the form submission.

17. Submit

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