EV Charger Estimate Form
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
1. Single Family, Multi Family, or Commercial Installation site?
*
2. Own Or Rent
*
Own
Rent
3. Do you have a level 2 Charger already?
*
Yes I have one, Or I plan on buying my own
I would like you to include the charger in the estimate
4.If you are providing the charger, what is the make and model?
*
5.What Make and Model Car Did YouBuy?
*
6. Where do you want the charger installed?
*
Inside my garage
On the Exterior of the house/ building
Other
7. Is your house Pre wired for an EV Charger?
*
Yes
No
Not sure
8. What year was your house built?
*
2015+
2000-2015
1990-2000
1990 and older
9.Do you have any of the following (select all that apply)
Electric Oven
Electric Cook Top
Central A/C
Pool
Hot tub/Spa
Electric Water heater
Electric Dryer
Solar
Existing EV Charger
Steam Unit
10. Please upload a Picture of your main Electrical panel on the exterior of the house so I can see the Breakers and labels.
*
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11. Please upload a picture of any other electrical panels you may have so I can see the breakers and label.
*
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12. Standing back 10ft, Please upload a picture of the area you would like the Charger installed.
*
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13. Approximately how many feet from the main electrical panel is the Charger installation location?
*
14. Any Additional comments or information you would like to add?
15. How did you hear about us?
*
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