Please enter all data fields below to complete your access request to BGE's Midstream Online Intake Tool (OIT). Once your participation is verified with your affiliated Distributor(s), BGE's Midstream program team will provide you with your unique access credentials.

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* 1. Company Name as you would like it to appear on the Utility website.

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* 2. Please select your affiliate Distributor(s) for participation verification

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* 3. Select the BGE Program you would like to participate in.

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* 4. Would you like to participate in any of these other utility programs?

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* 5. Enter Active MD License Detail, as applicable

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* 6. Email Address to be used for OIT Access

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* 7. Email Address to be used on the Utility Website for customers to contact you (if different from above.)

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* 8. Company Contact Name

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* 9. Website

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* 10. Phone Number

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* 11. Phone Number to be used on the Utility Website for customers to contact you (if different from above.)

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* 12. Street Address

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* 13. City

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* 14. State

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* 15. ZIP Code

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