*First Name:
*Last Name:
*Day Phone:
*Evening Phone:
Mobile Phone:
*E-mail:
*Street Address:
*City:
*State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
*Zip:
*County of Residence:
*What product(s) are you interested in?
*Who is your Electric Service Provider?
Please choose one
SCE
PG&E
Other
*Do you use an air conditioning unit to cool your home?
*What is the construction of your home/business?
*What type roof does your home have (composition shingle, tile, etc)?
Please choose one
Composition Shingle
Flat Cement Tile
Spanish Tile
Rolled "Peel & Roofing"
Other
How is your electric bill calculated? Please refer to your utility bill.
What is your annual kilowatt-hour usage? This can be calculated by simply adding the kWh usage from your last 12 month’s utility bills.
Please choose one
7000-7999 kWh
8000-8999 kWh
9000-9999 kWh
10,000-10,999 kWh
11,000-11,999 kWh
12,000-12,999 kWh
13,000-13,999 kWh
14,000-14,999 kWh
15,000-15,999 kWh
16,000-16,999 kWh
17,000-17,999 kWh
18,000-18,999 kWh
19,000-19,999 kWh
Other
Does your roof have southern exposure?
If so, what are the approximate dimensions of the roof with southern exposure?
Approx. Length
5 ft
8 ft
11 ft
14 ft
17 ft
20 ft
23 ft
26 ft
29 ft
32 ft
35 ft
38 ft
41 ft
44 ft
47 ft
50 ft
53 ft
56 ft
59 ft
62 ft
65 ft
68 ft
71 ft
74 ft
77 ft
80 ft
Approx. Width
5 ft
8 ft
11 ft
14 ft
17 ft
20 ft
23 ft
26 ft
30 ft
What is your roof pitch or angle of elevation? (If known).
Example response: 5 & 12 pitch or
Questions and/or comments:
