Charger Installation Request Form

Quotation Request

Congratulations on your new car! Let us know where we need to install the charger for you.
Full Name*

First NameLast Name
Phone*

Area CodePhone Number
E-mail*
Address*

Street Address

Street Address Line 2

CityProvince

Postal Country
What days work best for you?*

MondayTuesdayWednesdayThursdayFriday
What time works best for you?*

MorningAfternoon
Any specific date/time?

DayMonthYear
What type of home do you live in?*

Single-FamilyDuplexRow/TownhouseCondominium
Car Make & Model
What Dealership did you purchase your EV from? (if applicable)
What is the name of the Dealership Salesperson? (if applicable)
What is the amperage of your current Electrical Panel?
Do you need a charger included with your Installation?
Location of Electrical Panel?
What is the approximate distance from Electrical Panel to the EV Charger Location?
Upload a picture of your Electrical Panel (please make sure all labels are legible)

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Upload a picture of the room where the Electrical Panel is located (stand back as far as possible from the panel)

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Upload a picture of the desired location of the Charging Station

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Should be Empty:

Quotation Request