Energy Ventures Series
2014 Fellowship Projects
Each teammate must complete a form in order to receive prize(s).
Team Name (as submitted on iStart)
eRespond (First place)
EnerGage (Second place)
ReGrid (Third place)
Binary Smart Plugs (Semi-finalist, $200 prize)
Intelligent Streetlights (Semi-finalist, $200 prize)
Mobile App for Better Grid Response (Semi-finalist, $200 prize)
Mobile Phone APP (Semi-finalist, $200 prize)
Outage Alert App w/ Rewards Program (Semi-finalist, $200 prize)
Program Inspecting Social Media (Semi-finalist, $200 prize)
Address (location to mail prize check)
Personal Biography for publication (including your major/degree, work experience, etc.) Please write in 3rd person (no "I")
One one member from your team needs to fill in the portion below
Briefly summarize your project (one entry per team required)
URLs to social media or website (if applicable; one entry per team required)
Taxes and waiver
Each teammate must agree with and accept the terms of the below affidavit and deliver it properly completed and notarized along with a completed W-9 to
Spark Clean Energy
C/O Mark Silberg
600 Davis Street FL 3W
Evanston, IL 60201
by 5 p.m., January 30, 2015, in order to take be awarded your prize. If we do not receive your properly completed and notarized affidavit by January 30, 2015, your prize may be forfeited.
IRS W-9 Form
(only necessary if your prize value exceeds $600)
(must be notarized)
The information I have submitted above is accurate to the best of my knowledge. I hereby give permission to Spark Clean Energy, Exelon Corporation, and ComEd to publish my information, photos, and documents provided above and as agreed in the above signed and notarized affidavit.
Yes, I agree
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