Variable Budget Billing Application

I am interested in the Variable Budget Billing Plan. Please calculate what my monthly payment would be if I enrolled. I understand there’s no obligation. A Nolin RECC representative will contact you regarding this request:
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Date to Start Budget Billing*
MM slash DD slash YYYY
Daytime Phone*
Evening Phone (if different from daytime)
Email Address*
Account Number*
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Email
This field is for validation purposes and should be left unchanged.