Maui Gas Inquiry Form

Thank you for your interest in making the switch to gas. For a limited time, The Gas Company is pleased to announce an exclusive offer for Maui residents. Now you can take advantage of standard gas service installation for FREE! Complete the form below for more information on the free installation offer and for personal assistance from a Gas Company professional.

You can also earn $100 credit to your gas bill with each new gas appliance you purchase. Fill out the rebate form at www.hawaiigas.com/rebate to redeem your $100 credit.

* First Name:

* Last Name:

* Email:

* Address Line 1:

Address Line 2:

* City:

* State:

* Zip:

Phone:
- Home Work Cell

What applications are you most interested in for gas service?

Cooking
Water Heating
Clothes Drying
Tiki Torches or Outdoor Lighting
Other:

Which of the following is most important to you?

Energy Efficiency
Environment
Reliability
Quality of Appliance
Safety
Other:

How did you hear about this promotion?

Direct Mail
Newspaper Advertising
Radio Advertising
Referral from Friend or Family
Employee of The Gas Company

Are you planning a home renovation project?

Yes No

Submit the word you see below:

Terms and Conditions for Maui Free Install

Free Installation is for standard gas service up to $300.00.
Installation cost over $300.00 is to be paid by the homeowner.
Free Installation offer only available on Maui and expires June 30, 2012.
Installation must be completed within two months of site visit.
Residential Appliance Credit Program Terms and Conditions apply.
The Gas Company reserves the right to alter or discontinue this program at any time without prior notice.