RESIDENTIAL            SERVICES                     COMMERCIAL

IT IS IMPORTANT TO FILL OUT THIS FORM COMPLETELY TO HELP US SO THAT WE DO NOT HAVE TO TAKE UP YOUR TIME WHEN WE SURVEY YOUR RESIDENTCIAL OR COMMERCIAL BUILDING All information submitted on this form is secure and will not be given to any third party for marketing

	Name
	Address
	City
	State
	Zip Code
	Home Phone
	Work Phone
	Fax
	Are you familiar as to how photovotaic cells work? Yes No
	What prompted your inquiry News Paper Friend One of our Customers Internet Magazine
	When would you want your solar system installed? 1-3 months 6 months 1 year Other
	Who is your utility company ARIZONA PUBLIC SERVICE SALT RIVER PROJECT UNISOURCE OTHER
	What is your average electric bill in KWH? (total divided by 12 mo)
	What is your average electric bill $ (total divided by 12 mo)
	Where do you anticipate your pannels being mounted? ROOF GROUND SINGLE TRACKER DUAL TRACKER OTHER
	Are you familiar with rebates, federal and, state tax incentives? Yes No
	What particular budget do you have in mind? 5 thousand 10 thousand 15 thousand 20 thousand 30 thousand 40thousand
	Are you interested in a financing package? Yes No
	Email