HOMEOWNER PROFILE FORM
Last Name:
First Name:
Street Address:
City:
State:
Zip:
Home Phone Number:
E-mail address:
Where did you learn about Solar Home Energy Solutions?
Advertisement
Web Site
NJCEP
Article
SHES Customer
Other
Home Owner Goal(s):
I/we want to:
Reduce our Energy bill
Take advantage of NJ Rebate Program
Create "Green Power" and reduce pollution
With the money I/we save from lowering our Electric bill, I/we plan to:
Invest in other energy saving natural gas appliances, windows, insulation, etc.
Pay off other loans/bills
Increase monthly savings for (College, Retirement, etc.)
If a Solar Solution can meet your needs, when would you want your installation?
Summer
Fall
Winter
Spring
Home Information:
I/we have lived in our home for:
years
Approximate age of your home:
< 10 yrs
10 yrs
12 - 18 yrs
20 yrs
> 25 yrs
How many bedrooms?
1
2
3
4+
How many bathrooms?
1
2
3
4+
Our home is a:
Single Detached
Attached
Duplex
Multiple
Approximately how old is your roof?
< 5 yrs
< 10 yrs
> 10 yrs
> 15 yrs
What general direction does your roof face?
North & South
East & West
What percentage of your roof is shaded by tree on your property?
None
< 10%
< 50%
> 50%
Are you willing to cut down trees that shade your roof?
Yes
No
Are there parts of your roof shaded by trees / structures that are not on your property?
Yes
No
From your most recent electric portion of your Energy Bill:
Monthly dollar amount charges for only electricity:
< $75
$75 - $85
$90 - $100
$100 - $115
$125 - $135
$135 - $150
Amount of electricity your home used:
kWh
How many years of Energy Bills we have to refer to for estimating our electric energy use?
1
2
3
3+
Best day of the week and times to contact us:
Moorestown, NJ • (856) 255 - 5727
