Business extra care form

Join our business extra care register

This is a FREE service to help reduce the impact of power cuts to our business customers

The fields marked with an asterisk (*) are required.

This field is required
This field is required This field has a maximum limit of 30 characters
This field is required This field has a maximum limit of 30 characters
This field is required Contact numbers should be between 11 and 25 digits long
This field is required This is not a valid email address (e.g. johnsmith@domain.com) This field has a maximum limit of 100 characters
This is not a valid email address (e.g. johnsmith@domain.com) This field has a maximum limit of 100 characters
This field is required This field has a maximum limit of 30 characters
This field is required

{[{user.SubBuilding}]}, {[{user.AddressLine1}]}, {[{user.BuildingName}]} {[{user.AddressLine2}]}, {[{user.AddressLine3}]}, {[{user.City}]}, {[{user.Postcode}]}

Wrong address? Re-enter it again or click below to enter your address manually.

This field is required This field has a maximum limit of 970 characters
Address must have either building name, building number or both This field has a maximum limit of 30 characters
Address must have either building name, building number or both This field has a maximum limit of 970 characters
This field is required This field has a maximum limit of 80 characters
This field has a maximum limit of 30 characters
This field is required This field has a maximum limit of 30 characters
This field is required This field has a maximum limit of 10 characters
Postcode is not within the Electricity North West area
This field is required

Contact Preference

This field is required

Do you need electricity to operate?

This field is required

Do you have your own backup generator?

This field is required
This field is required