EZ Ride - Charge @ Work Pledge

1

Full Name* This field is required.

First Name

Last Name

2

Company Name* This field is required.

3

Worksite address* This field is required.

Street Address

Street Address Line 2

City

State

Zip Code

Country

4

Phone Number

5

E-mail* This field is required.

example@example.com

6

Number of employees* This field is required.

<10

10-100

100-1000

>1000

7

Are you ready to deploy workplace charging in the near future?* This field is required.

not yet

yes: 1-4 plugs

yes: 5-10 plugs

yes: 11+ plugs

8

Would you like to coordinate with EZ Ride on your journey?* This field is required.

YES

NO

9

As an employer in the U.S., we are committed to include electric vehicle charging and access to clean transportation at our workplace. As part of our commitment, we will consider: (select at least one)* This field is required.

Installing workplace EV chargers

Providing workers with educational materials on electric transportation

Developing transportation electrification plans

Hosting EV test drive and informational events

Creating EV purchasing incentives for workers

Developing e-mobility affinity groups

10

Signature* This field is required.

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11

How did you hear about us?

12

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