Name:

Company Name: (if applicable)

Your Address:

City:

State:

Zip:

Phone:

Fax:

E-mail address:

How did you hear about us?:

Any questions, concerns or comments that you may have:

How would you prefer us to contact you:

Phone Email Regular Mail
 

How soon were you planning on starting a solar project:

Soon as possible 1-3 Months
6-9 Months 1 year or longer
Not Sure
 

Is this installation for your home or business: If business, what type of business:

Commercial/Industrial Agricultural
Government Non-profit
Educational Other
 

Give us an idea of your average monthly electrical bill:

Under $100 $200-500
$500-1000 More than $1000
 

How old is your building:

How old is your roof:

Please provide any of the following information: (Click button if applies)

Are there trees on your property?
Are there any in the area where the solar electric system is to be installed?
 

Is there anything visible that may cause shading in the area for the system? (ie: roof may have hvac unit, higher parts of the roof can shade the area where the system is to be installed, any adjacent buildings, telephone poles, etc.)

How large is the space or roof that would house the system? (Square footage if possible)

What type of roof do you have?

Flat roof Pitched roof
 

Any additional comments or questions