Diverse Energy

*Name:

*Company:

Position:

*Email Address:

*Telephone Number:

Mobile Number:

I work for a:

-----Please Select---- Cell phone operator Cell phone equipment manufacturer Cell phone equipment installer Cell phone tower company Generator maintenance company Power (electricity) provider / utility Fuel / ammonia provider Testing Laboratory Government / Regulator Environmental group Bank; Lease Agency Student; Academic Component Supplier Other (specify below)

If other please specify:

I am interested in: (Tick any boxes that apply):

Purchasing PowerCubes^®

Leasing PowerCubes^®

Providing leasing finance

Providing logistics support

Becoming a component supplier

Working at Diverse Energy

Sales and distribution of ammonia

A student internship / sandwich year

Other (specify below)