Register Complete and submit this form to register for the Oil to Heat Pump Incentive Program. Homeowner InformationName* First Last Address* Street Address City Postal Code Phone*Email* Oil Tank InformationMy oil tank is (select one):*InsideOutside above groundOutside below groundHeat Pump InformationAsk your contractor for this informationHeat Pump type*Air to air centralAir to air mini-splitAir to waterAHRI Reference Number*Ask your heat pump installer for this information.Make and model numbers for all components*Ask your heat pump installer for this information. Accredited Installer InformationDo you intend to work with an Accredited Contractor for your system installation?*YesNoWhat does Accredited Contractor mean?Course CompletedTECA Quality First Forced Air Guidelines CourseHRAI SkillTech Residential Heat Loss/Gain and Air System Design CoursesASTT Registered Applied Science Technologist, MechanicalCompany Name*Name of heat pump installation company. Accredited Contractor Name*First and last name of installer who has completed the accreditation course(s). Course CompletedTECA Quality First Hydronics and Combo CourseHRAI SkillTech Residential Heat Loss/Gain and Radiant Hydronics Design CoursesASTT Registered applied Science Technologist, MechanicalHow did you first hear about the Oil to Heat Pump Incentive Program?Heat Pump InstallerLetter from my local governmentOther communication from local governmentUtility provider (e.g. BC Hydro, FortisBC)Energy advisorMedia (newspaper, radio, TV)OnlineWord of mouthHomeowner DeclarationBy submitting this form, I confirm that: I am the/an owner of the property listed above. My home is currently primarily oil heated and no heat pump is currently installed. (A primary heating system is defined as a heating system with the capacity to heat a minimum 50% of the home for the entire heating season to 21oC.) I have read and will comply with all Oil to Heat Pump Program Terms and Conditions. I understand that my personal information on this registration form is being collected for the purpose of processing my application for an incentive and otherwise administering and evaluating the Oil to Heat Pump Program. I understand that the protection of my personal information is governed by the Personal Information Protection Act and questions about the use of my personal information collected through the Oil to Heat Pump program can be directed to the Oil to Heat Pump Privacy Officer at 1-877-545-6247 or firstname.lastname@example.org. I agree to be contacted by City Green by phone, email, direct mail, or similar method for the purposes of administering, evaluating, and researching all elements of the Program effective from the date I sign this form until one year following the close of the Program. I understand that registering for the Program does not guarantee my access to the oil to heat pump incentive, and that I must comply with all Terms and Conditions. I understand that successful applicants will receive a registration number, and that a completed application form must be received within 6 months of the date of issue of the registration number, or March 31, 2018, whichever comes first.