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Broker Application Form

We are always growing.

Champion Energy Services is committed to developing relationships with other industry leaders to provide a variety of energy solutions and deliver Best in Class customer service. If your firm shares this vision, please take a moment to tell us a little more about yourself and your company. We’d love to hear from you.

Company Information






















Customer Base

What is the size of the annual load represented by your company (in MWhs)?

How much of your customer base is included in the following annual use ranges (expressed as a %)?






In which markets are you licensed? Please provide your license number for each state.

















Customer or Retail Electric Industry References

A minimum of three energy-industry references is required to complete the Broker Application.




Why do you want to work with Champion Energy?

AGREEMENT AND SIGNATURE

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if I am accepted as a broker, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal. If this application is accepted, a third party agreement must be executed between both parties in order to begin transacting.

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