Kitchener Utilities: Online Form

Natural Gas Appliance Protection Plan Form

Please complete the online form below. If you have any questions, please contact Kitchener Utilities by sending an e-mail to utilities@kitchener.ca.

** If your request is an emergency, please call our 24-hour Dispatch Centre at 519-741-2529.**

Please note: * indicates that the field is mandatory

I would like to sign up for the Appliance Protection Plan for:*

Are you the:*
Registered Owner
Tenant
First Name:*

Last Name:*

Address for water heater:*

Apartment or Unit #:

City/Province:

Postal Code:*

Daytime Phone Number:

Would you like to sign up for future e-mail notifications from Kitchener Utilities?*
Yes, I give consent to receive free future communications from Kitchener Utilities.
No, thank you.
Note: If you would like to receive further communications, you must provide your e-mail address.
Email Address: