Partner Application Form

If you would like to become a partner with Bounce Energy, please fill out this form and one of our Business Development representatives will be in touch with you.

The Basics

First Name	*
Last Name	*
Address, Line 1	*
Address, Line 2
City	*
State	*
Zip	*

Phone 1	*
Phone 2
Email	*

Organization Name	*
Position	*

Tell Us About Your Business or Organization

Overview of Your Company or Organization:
*

Main Web Site Address:
*

How long have you been in business (or how long has your webe site been live)?
*

Additional Domains Used: (if applicable)

Web Site Visitors (Traffic must be verifiable by compete.com, alexa, etc.)
*

Primary Methods of Driving Sign Ups for Bounce Energy (i.e. Internet Marketing, Facebook Page, Events)
*

Geography

MSAs/Cities Covered?
*

Demographics/Site Content

Describe the Demographics of Your Website Visitors, Customers or Members
*

Number of Referrals Currently Sent to REPs on a Monthly Basis from Your Website(s):

Please verify you're a real person by doing this simple math problem:

8 + 2 =

Bounce Energy Low Texas Electricity Rates. Great Rewards!

Partner Application Form

Geography

Demographics/Site Content

Company Information