First Name
Last Name
Who referred you to us (isn't this great!)?
Address
City
State
Zip
Email
Best daytime phone number
Mobile Phone
We have your permission to text you?
True
False
Utility
(GMP) Green Mountain Power Corporation
(VEC) Vermont Electric Coop
(BED) Burlington Electric Department
(WEC) Washington Electric Coop
Stowe Electric Department
Morrisville Water & Light Department
Town of Northfield
Barton Village, Inc.
Hardwick Electric Department
Ludlow Electric Department
Lyndonville Electric Department
Rochester Electric Light & Power
Swanton Electric Department
Town of Readsboro
Village of Enosburg Falls
Village of Hyde Park
Village of Jacksonville
Village of Johnson
Village of Orleans
Central Hudson Gas & Electric
Con Edison
KeySpan Long Island
National Grid
(NYSEG) New York State Electric & Gas
(RG&E) Rochester Gas & Electric
Name on Utility Bill
In order to find out how much electricity you use, we will need to contact your utility. You are okay with that, right?
true
false
How Old Is Your House?
Less than 50 years old
More than 50 years old
Not sure
Roof Type
Asphalt shingle
Standing seam metal
Slate
Cedar shakes
Not sure
Corrugated Metal
Rubber Membrane
Cement/Terracota tile
Other
How Old Is Your Roof?
Less than 10 years
10-15 years
15-20 years
Older than 20 years
Not sure
How do you heat your home?
Oil
Propane
Natural gas
Wood
Electric baseboard
Other
Pellet Stove
Heat Pump
How do you cool your home?
Window fans
Window A/C
Central A/C
Other
We don't cool
Heat Pump
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