What is your name?
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What is your primary interest in going solar? (check all that apply)
*
Cost Savings
"Clean" Impact
Tax Advantages
Energy Independence
Other
What is your current housing situation?
*
I own my home
I rent my home
I rent, but will be buying a home soon
I am inquiring for other reasons
Are you the head of the household, or is there another decision maker?
Please Select
I am the only decision maker
I have a joint decision maker
Who is your current electric utility provider?
*
Company Name
What is the average monthly charge of your electric bill?
Please Select
less than $50/month
$50-$100/per month
$100-$150/per month
$150-$200/per month
$200-$250/per month
greater than $250/per month
What is your average credit score?
Exceptional (800-850)
Very Good (740-799)
Good (670-739)
Fair (580-669)
Poor (300-579)
I would prefer to discuss later
What email can we reach you at?
*
example@example.com
What is the best number to reach you at?
*
Please enter a valid phone number.
Would you like to include any additional helpful notes or questions? If so, please add them here.
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