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Thanks for your interest in an HOURCAR membership. Please complete all required fields in the form below. If you have any questions during this process, call us at 612-343-CARS (2277).

* indicates a required field. The application will not be processed without this information.

New Applicant - Member Application Form

Thursday, April 24, 2014
Organization
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Organization Contact Information
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Payment Information
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Credit Card Information

Payment Method: Credit Card

Card Number:    *
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Check this box if your Credit Card Address is different from your Primary Address
Make checks payable to HOURCAR / NEC. Mail your check or money order along with your completed application to:

HOURCAR Membership
Neighborhood Energy Connection
624 Selby Avenue
Saint Paul, MN 55104
Bank Account Information

Payment Method: Bank Account

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Transit Number (ABA):   *  
Account Number:   *  
Promotions
Promotion:  
Referrals and Promotions
How did you find us? *
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Please provide specific details if you can:
Did a member refer you? Who?
Verification
By submitting your application to HOURCAR, you
  1. Verify that everything stated in the application is true.

  2. Authorize HOURCAR, its agents, and insurers to review your credit history, driving record, criminal record, and other background information as HOURCAR shall deem relevant to its approval of Member's participation in the HOURCAR program.

  3. Understand that the information provided by you and the review of your driving record will be retained by HOURCAR and its agents and insurers, whether or not your application is approved.

I understand and accept
 
 

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