Clean Energy for Raleigh This form contains three sections. We recommend that you have your utility information ready before you begin. If you are enrolling new construction or do not have complete data, that is okay. Please fill in as much information as you can; make an educated guess if you are unsure; and use the comment box at the end to share any additional information relevant to your situation. We will follow up with you if we need more information. After you have submitted your form, we will review your information and pass it on to the appropriate contractor. They will contact you to set up a free and no-obligation home energy audit or solar site assessment. We will keep your information secure and confidential and will only use it for this campaign. Thank you again for taking the first step towards adopting clean and more efficient energy in your home, business, or organization. Step 1 of 3 33% Are you applying a residence, business, or tax-exempt entity?ResidenceBusinessTax-ExemptWhat is the name of the business?What is the name of the entity?What is the physical address of the site you are enrolling?We will use satellite imagery to assess the site for solar suitability. Street AddressCityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificStateZIP CodeWhat is your name? (First and Last)*FirstLastWhat is your relationship to the site you are enrolling? (i.e. owner, manager, occupant)What is your email address?What phone number should we call if we have questions about your assessment?Use this format: (###)###-####How did you hear about the Clean Energy for Raleigh campaign? What electricity company services your site?DukeWake EMCOtherPlease specify your electric company:What is your primary interest(s)?Solar Photovoltaic (PV)Solar ThermalEnergy EfficiencyOtherI don't knowPlease specify your other interest:Are you primarily motivated by economic or environmental reasons or both?EconomicEnvironmentalBothHave you ever had an energy efficiency audit performed?YesNoWho performed the energy audit?Have you ever had a solar site assessment performed?YesNoWho performed the solar assessment?If you are interested in solar, please describe the repair, age, and composition of your roof:Please upload your most recent bill for the following utilities (if available): Fuel, Electric, WaterUpload all that apply. The limit is 8MB.Drop files here or Please describe the site’s utility usage:Ideally this includes two years of electricity data (Kwh per month), two years of fuel data (gallons for fuel oil; therms for gas; cords for wood), and two years of water data (CCF.) If you cannot find the units, then use the dollar amount.How do you heat your site?OilNatural GasElectricityPropaneHeat PumpOtherPlease specify your other heating source:How do you heat your water?Natural GasElectricityPropaneOtherPlease specify your other water heating source:Year structure was built:Square footage of structure:Number of people using structure: If you are a homeowner or business owner, will you pay federal taxes this year?YesNoI don't knowIf you are a homeowner or business owner, will you pay NC state taxes this year?YesNoI don't knowA basic energy efficiency retrofit costs between $2,000 - $5,000. Financing is available. Is this a comfortable spending range for you?YesNoN/AA typical solar thermal system costs between $7,500 - $9,000. At this time, the ideal solar customer can get up to 60% of this cost back from tax credits. Financing is available. Is this a comfortable spending range for you?YesNoN/AA typical solar PV system costs between $15,000 - $25,000. At this time, the ideal solar customer can get up to 60% of this cost back from tax credits. Financing is available. Is this a comfortable spending range for you?YesNoN/ADo you plan to purchase directly or would you like to explore financing?Purchase DirectlyExplore FinancingDo you have an open home equity line of credit (HELOC) or the ability to get one?To get a HELOC, you must have equity in your home and a decent credit score. For more information on HELOC, see the Wikipedia article: HELOC - Home Equity Line Of CreditYesNoI don't knowDo you make passive income?There are unique solar opportunities for individuals with passive income. Passive income is derived from trade or business activities in which you “do not materially participate” or income derived from real estate properties (unless you work as a real estate professional).YesNoI don't knowAny additional comments or questions you have here:EmailThis field is for validation purposes and should be left unchanged.