Power Your Drive for  Apartments, Condos, and Workplaces - Customer Interest List

 

Applicant Information

First name

Last name

Applicant Affiliation to Business/Property

Manager

HOA Representative

Electric Vehicle Service Provider (EVSP)

Contractor

Representative of Public Site

Business phone

Cell phone

Email

Customer address

Address

City/Town

State

- Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle EastArmed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

ZIP/Postal Code

Project Site Information

Business Name / Property Name

Project Site Address

Project Site Address

City

State

ZIP/Postal Code

Site Type

Apartment/Condominiums

Workplace

Mixed Use (Residential & Business)

Public site (within half a mile of one or more apartment/condominium complexes)

How many complexes?

Parking Lot Type

Surface

Underground Garage

Above Ground Structure

Mixed Lot Installation

Known Number of EV Drivers?

Number of Charging Nozzles Desired?

Chargers Needed for: (select all that apply)

Residents

Employees

Public

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