Electric Vehicle

EV Test Drive Application

EV Test Drive Application

Member Name (as it appears on your driver's license)
Member Name (as it appears on your driver's license)
First
Middle
Last
RECC Service Address
RECC Service Address
City
State
Zip Code
Terms of Agreement
By checking this box, I have read and agree to the terms of this Temporary Loan of Electric Vehicle Agreement, and represent all statements made herein and are true and correct. I understand that by typing my full name below and pressing the Submit button, this application will be stamped with today's date and authoried by me as if I had signed my Signature.
Type your full name.