We appreciate your interest in Collectron Energy. To ensure a productive call, please fill out the information requested below before we proceed with scheduling. Your provision of detailed information will aid in optimizing our call's efficiency. We look forward to talking with you soon.
Customer Info
Name
First Name
Last Name
Email
example@example.com
Phone Number
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Company Name
Your Title at the Company
Your Guide
Youtube
Site Info
What is the address where the chargers will be installed?
Street Address
Street Address Line 2
City
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District of Columbia
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State
Zip Code
Geolocation
Electrical utility company at the charger site
What are your goals for this project?
Site Contact
Name
First Name
Last Name
Email
example@example.com
Phone Number
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Project Details
How quickly would you like your charger installed?
Please Select
ASAP
1-2 Months
3 Months+
Just looking for an estimate
How many electric vehicles do you need to charge at one time?
What type of vehicles will you be charging?
Light-duty vehicles (Passenger vehicles, vans, trucks)
Medium-duty vehicles (Box trucks, delivery trucks, buses)
Heavy-duty trucks (18-Wheelers, tractors)
How do you want the chargers to be mounted?
Please Select
Pedestal
Wall
Both
Other
Not Sure
Who will be using the chargers?
General Public
Employees
Specific Individuals
Residents
Not Sure
Location Map
Please provide at least one Electrical Panel location
Please provide at least one EV Charger location
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Supporting Documents
Upload any of the following documents: (1) Last 30 day complete electric bill (2) construction as build and (3) parking level diagram
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