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Church/Business name:
Denomination (if church):
Other, please specify:
Supply Address:
Post code:
Website:
District/Circuit/Diocese:
Billing Address: (if different from above)
Post code:
Contact Name:
Contact Address:
Position:
Telephone number:
Email Address:

Electricity (sum of kWh usage on 4 quarterly or 12 monthly bills)

Top line Bottom line
MPAN : S
S
S
S
S
Current supplier :
kWh per year
Standing charge (£ per year):
Day (pence/kWh ):
Night (pence/kWh ):
Evening/Weekend (pence/kWh):
Other (pence/kWh):
     
Est. total annual consumption ( kWh)  
Specify if the above relates to current prices or a renewal offer:
Current Renewal
If you are on a contract please show your renewal date:
Renewal date:

Gas (sum of kWh usage on 4 quarterly 12 monthly bills)

Current supplier :
Standing Charge (if applicable) £ per year:
Gas pence/kwh
Annual Consumption (kWh - not units)
MPR (not Meter Serial)
Contract Renewal Date