ZAP Partner Interest Form

Zero-Emission Assurance Project (ZAP) Partner Interest Form
Thank you for your interest in partnering with the Zero-Emission Assurance Project (ZAP).

This program, established by the California Air Resources Board (CARB), provides financial assistance to low-income Californians for the repair or replacement of battery packs, system critical or fuel cell components in used zero-emission (ZEV) and near-zero emission vehicles (NZEV).

ZAP also supports workforce development in advanced vehicle technologies. We are seeking qualified diagnostic and repair facilities to join our network and help us achieve our goals.

Please complete the form below to express your interest in participating in ZAP.
Facility Information
Facility*
Legal Facility Name
Contact Person Title*
Facility Position Title
Contact Person Name*

First NameLast Name
Facility Email*
example@example.com
Facility Location*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Facility Phone Number *
Facility/Business Phone NumberFormat: (000) 000-0000.
(ARD) License#
What type of partnership are you interested in? (Select all that apply) *
Select all that apply (Ctrl+click selection)
What fuel type does your facility offer services for?*

Battery Electric Vehicle (BEV)Pug-in Hybrid Electric Vehicle (PHEV)Fuel Cell Electric Vehicle (FCEV)All of the Above
Vehicle Makes *
Vehicle makes of Near Zero-Emission Vehicles serviced by your facility

Rows	Diagnostic	Repair	Repurpose	Recycle	Educational Training
Battery Electric Vehicle (BEV)
Pug-in Hybrid Electric Vehicle (PHEV)
Pug-in Hybrid Electric Vehicle (PHEV)

Zero-Emission Assurance Project (ZAP) Partner Interest Form