Minnesota Power DCFC Fast Charging Project Site Selection Request Form

1. Business Name *This question is required.

2. Primary Contact Name *This question is required.

3. Primary Phone Number *This question is required. (ex. 555-555-5555)

4. Primary Email Address *This question is required. This question requires a valid email address.

5. Minnesota Power Account number (if applicable): This question requires a valid number format.

6. Proposed DC Fast Charging Site Address:

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

7. Does your site satisfy the following requirements?

Site is located in or near target locations: Bigfork, Cohasset, Cloquet, Duluth, Floodwood, Eveleth, Hermantown, Hinckley, International Falls, Little Falls, Long Prairie, Park Rapids, Silver Bay, Highway 371, Highway 53

You are a current Minnesota Power Customer

Site is within one mile of a Highway, Interstate or Major Travel Corridor

8. Tell us why your business would be a great fit for a DC Fast Charger. Include information about amenities at or near your location: *This question is required.

8. If selected, what date could construction of charging station(s) begin: *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

8. If date is far into the future- please explain:

8. Is there anything else you would like to share with us?