Check Grant Eligibility

To start the grant eligibility evaluation process, please complete this initial eligibility form. We will contact you upon receipt to proceed to the next step in the grant evaluation process.

Applicant Information

Legal Name of Fleet/Vehicle Owner

Contact Name

Phone Number

Primary Address

Where are your vehicles domiciled?

Select all states where you have vehicles

What fuel type(s) are you interested in?

Are you working with a Rush Sales Rep?

If yes, please list their name. If no, list N/A.

Acknowledgement

By submitting my information, I agree that Rush Enterprises and Momentum Fuel Technologies and their affiliates may use my information to send me information and contact me about their products and services. To learn more about how your information can be used by us, please visit: https://www.rushtruckcenters.com/privacy-policy https://www.momentumfueltech.com/privacy We also use SmartSheet to process your information. To learn more about how SmartSheet may use your web usage data, such as your IP address, visit see Smartsheet's Privacy Notice at https://www.smartsheet.com/legal/privacy

Agree

Send me a copy of my responses

Report Abuse