Renewable Energy Customer Questionnaire

(to be printed out OR cut and pasted to an email and mailed to the above address)

If you would like a Renewable Energy Such as Wind Power Generator, Solar Power or Co-Generation Assessment of your home or business (including approximate cost), please complete this questionnaire to the best of your knowledge..

Name*
Date*
Address*
Address (where system will be installed, if different than above)
Contact Phone*
Other Phone
Email Address*
Do you want to receive notices of Wind Power Generator, Solar Power or Co-Generation sales, happening & legislative alerts?
YesNo
General Questions
Who is your electric company
This system is for a: Home Business Other
Your role: Owner Builder Architect Other*
Your reason for a Wind Power Generator or Co-Generation or Solar Energy System:
Clean Energy Energy independence
Hedge against higher energy prices Reliable energy Other
Are you interested in a photovoltaic (solar electric) system?
YesNo
Are you interested in a back up power system (UPS)?
YesNo
How did you learn about Visa Eneregy GB Energy Solutions?
Any additional comments
Determining Your Current Energy Use
Do you use Gas? Yes No If so what for:
How much do you use?
Winter month Summer month
Electricity Use- Preferred Method (most accurate)
Find your monthly electricity usage for each of the last 12 months (Labeled KWH on your bill) Total the 12 monthly usage figures to find your total annual usage. This is also available as a report from your electric company. Total Annual KWH usage:
Electricity Use- Alternative Method
Find the monthly usage for 2 or more months (Labeled KWH on your bill). If possible select one month from each season.
Spring
Summer
Fall
Winter
Determining Your Solar Array Location
Solar panels can be installed on a roof, trellis, on a pole or a ground-mounted rack.Where would you like to mount the panels? Roof Top of Pole Tracker (single axis) Tracker (single axis) Ground mount Power-Shed Garage Awning style Side of Pole
If on the roof, what type of roof do you have?
If you prefer a roof-mounted system, please answer the following
Is there an area(s) on your roof that is exposed to the sun most of the day?
YesNo
Approximate orientation of exposed roof area(s)
OneMore
East Southeast South Southwest West Other
What is the approximate square footage of exposed roof area?
Type of roof: Composite Tar & Gravel Rubber Wood shake Tin Tile Other
Approximate age of roof:
Number of stories on building:
General condition of roof:
Approximate slope of roof area: Flat 3:12(14 degrees) 4:12 (18 degrees) 6:12 (27 degrees) 12:12 (45 degrees) Other:
Getting Started
Approximately when would you want your system installed?
NowWithin 3 monthsWithin 6 monthsWithin a yearNot sure
Would you like assistance in obtaining financing?
YesNo
Please indicate the best time to contact you*
Comments