MINI-E Field Test Charger Sharing

Once you complete the form below to be included as a MINI-E charging station sharer, you will have access to list of other MINI-E field testers who are particapating sharers, including a labeled Google map. All fields are required. You can return at any time to make adjustments. Passwords must be 10 characters or less and are not case sensitive.

SIGN-UP FOR CHARGER SHARING

NAME:
ADDRESS:
CITY STATE ZIP:
E-MAIL:
PHONE:
PASSWORD:
  CAR #
CHARGE FEE $
 (FOR 30-60 MINUTE CHARGE)
NOTE ON ARRANGING ACCESS