Solar / Lighting / Windows Request
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Name (s)
*
First Name (s)
Last Name
Phone
*
Daytime # we can can TEXT to.
Email
Only we can view your email address.
Address
Street
Street Address Line 2
City
State / Province
Zip
Residence Status
Please Select
Full-Time
Part-Time here more than 6 months
Part-Time here less than 6 months
Any plan to sell / move?
Please Select
No
Yes - 5 years or less
Yes - 10 years or less
APS or SRP
Please Select
APS
SRP
Monthly utility cost
$
Equal pay amount or average monthly bill
Solar Status
Please Select
Had solar in the past
Never had solar
Currently have solar
Solar Knowledge
Please Select
No Solar understanding
Little Solar understanding
Some Solar understanding
Good Solar understanding
Extensive Solar understanding
Family or Friends with Solar
Please Select
Yes I have a family member with Solar
Yes I have a friend with Solar
Yes I have a family member and friend with Solar
I do not know anybody personally who has Solar
LED Lighting Knowledge
Please Select
No Lighting knowledge
Some Lighting knowledge
Good lighting knowledge
No Lighting knowledge
Family or Friends with LED Lighting
Please Select
Yes I have a family member with lighting
Yes I have a friend with lighting
Yes I have a family member and friend with lighting
I do not know anybody personally who has lighting
Roof
Please Select
New Roof
Roof age 5 years or less
Roof age 6-10 years
Roof age 11-20 years
Roof age 20+ years
Electrical
Please Select
100 amp electric service
150 amp electric service
200 amp electric service
400 amp electric service
How many amp service
Electric vehicle
Please Select
Own Ev
Ev - Yes in the future
Ev - Maybe in the future
No plans for Ev
Valuable to determine usage need
Appointment Type
Please Select
Telephone meeting
In-home meeting
To gather information and usage
Notes
Questions or concerns
Appointment Date & Time
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