Register for the DOE Challenge Home

Complete the online registration to become a DOE Challenge Home partner.

* Required Fields

Contact Information

* Organization Name (complete legal name - i.e. Acme, LLC):
* Organization Type:
Parent Organization (if applicable):
   
* Street Address (i.e. "123 Main St." - NO CITY; NO STATE):
* City:
* State:
* Zip:
* Primary Phone Number (numbers only, no hyphens or dots):
Website Address (complete - "http://www.example.com"):
   

Primary Contact

* Authorized Signature?
Yes No
* First Name:
* Last Name:
* Title/Role:
Complete Mailing Address (if different from above):
* Primary Contact's Direct Phone Number (numbers only, no hyphens or dots):
* Email Address (i.e. jdoe@example.com):
GovDelivery Subscription:
(To subscribe to the DOE Challenge Home e-newsletter, please enter your email address above, and click the following button.)
   

Upload your organization's logo

The format of this logo must be in the following formats: JPEG, JPG, PNG

 

All places your organization conducts business

 
 
 
Please know your account is subject to review. Your account will be approved and listed as soon as all requirements are met. You will receive a confirmation email once your account is approved.