Section 1: Customer Information


Name:

Mailing Address:

City: State: Zip Code:

Street Address (if different from above):

Home Phone #: # of people in household?

Work Phone #:   E-mail address:

Best way to contact you: Mail Home phone Work Phone E-mail

Section 2: Household Information


1. Who is your current electric distribution utility?

2. What is your average monthly electric use? (From utility bill)
Summer kWh Winter kWh

3. How do you heat your hot water?
Electric Natural Gas LPG Oil

4. What type of heating system is installed in your home?


5. Do you own the home you live in?
Yes No

6. How old is the electric system?
New Upgraded in last 10 years Older than 10 years

Section 3: System Site Information


1. What material is your roof made of?
Asphalt Standing seam metal Corrugated metal Slate or tile
Rubber membrane (flat roof) Wood shingle
Other

2. Does part of your roof face south?
Yes No

3. Is your south roof unshaded between 9am and 4pm?
No shade Partly shaded in winter Partly shaded in summer
Fully shaded part of the day

4. How large an unshaded area is available on the south roof?
4'x6' 8'x6' 12'x6' 8'x12' 10'x37' 10'x50' 10'x62'

5. How old is your roof (yrs)?
0-5 5-10 10-15 15-20 Don't know

6. Could the solar panels be ground mounted if roof is not suitable?
Yes No