EVEP X DCAP 2024-25 Intake Form

1

Please read the following carefully.

Thank you for your interest in the EV Equity Program. We are a San Joaquin Valley non-profit that works to connect and assist residents with the incentive application process. WE ARE NOT THE FUNDERS of the incentives. We are the community resource to provide support for the application process and provide education. Please fill out this form so we can best assist you. Check your email after you submit!

2

Please enter your first and last name* This field is required.

First Name

Last Name

3

Please enter your phone number* This field is required.

We use this to communicate program updates via call or text.

4

Please enter your email address* This field is required.The EV Equity Program and its staff primarily communicate via email. Please provide a valid email address that you have access to.

We will never send you spam or unnecessary emails. We do not share your info with other services

5

What county do you live in?* This field is required.

6

Have you redeemed any grants in the past from the California Air Resources Board?* This field is required.these would be incentive programs that have to do with electric vehicles.

YESNO

7

Do you live in a Disadvantaged or Low Income Community?* This field is required.If unknown, use your best guess. Our team will verify this information with you later.

YESNO

8

Please select the number of people living in your household* This field is required.This is based off your household listed on your taxes and anyone that is a dependent or you are financially responsible for.

1

2

3

4

5

6

7

8 or more

9