If you drive a plug-in electric vehicle that is registered in Midstate Electric Cooperative service territory, we would like to hear from you! As electric vehicle adoption increases, MEC needs to plan for system reliability and design programs that benefit our membership. By taking the time to fill out this short questionnaire, you will help your co-op have a better understanding of EV usage by our members – and you’ll earn a $100 incentive! To be eligible, you must: Be a Midstate Electric member Own or lease a new or used: Plug-in battery electric vehicle with a minimum 2 kWh on-board battery, or Plug-in hybrid electric vehicle with a minimum 2 kWh on-board battery Have your eligible vehicle registered at a service address with an active Midstate Electric service. Complete the online form. Midstate members are eligible to receive one registration incentive per vehicle. A new form must be completed if a member has multiple eligible electric vehicles. Submit proof of your active Oregon DMV registration document for verification. (scan document or a clear and legible photo image will do) After verifying your information, you will receive your $100 incentive! Vehicle Registration Information Full Name (Last, First): Mailing Address: Address City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Service Address: Address City/Town State/Province - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code MEC Member Number or Account Number: Email Address: Phone Number: Vehicle Make and Model Average Miles Driven Weekly Where will vehicle primarily be charged? - Select -HomeWorkPublic Charging Is the primary charging location in Midstate service area? Yes No Do you plan on installing a level 2 charger at home? Yes No Maybe Already Installed What location in Midstate service area would most benefit from having public charging? Upload Proof of DMV Registration Upload Upload requirementsOne file only.100 MB limit.Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Leave this field blank
