Free Home Energy Audit Sign-Up Form

Free Home Energy Audit Sign-Up Form

You may complete this form online and press submit or you may print it out and fax it to (919) 872-3356. Items with a red astrisk are required fields.
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
What are you hoping we can help you with? (Check all that apply.)
Does anyone in your home suffer from any of the following medical conditions?
Have you had a whole house check up or energy audit in this home before? If so, who did it?
How would you rate the importance of having a whole house check-up done on your home.Please check all that apply.
How long have you owned your home?
How Many People Live in Your Home?
Please Tell Us a Little Bit About Your Current Energy Use.
What Types of fuel sources do you use.
Annual Electicity Cost
Annual Natural Gas Cost
Annual Propane Cost
Annual Fuel Oil Cost
Annual Other Fuel Cost
What Electric Company are you with?
What Gas Company are you with?
How many thermostats does your house have?
At what temperature do you normally set your thermostat in Winter?
At what temperature do you normally set your thermostat in Summer?
Home energy audits typically take about 2-3 hours and we do ask that all homeowners be present. What is the best time to fit this into your schedule?
Thank you very much! Enter the word below and then click submit. One of our energy auditors will be in touch shortly
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Free Home Energy Audit Sign-Up Form

Please Tell Us a Little Bit About Your Current Energy Use.

Thank you very much! Enter the word below and then click submit. One of our energy auditors will be in touch shortly