Please fill out this form as completely & accurately as possible.
Items marked with an asterisk (*) are required for the form to process.
This form does work, is pertinent, and will help us to help you.

First

Last

Address

City

State

Zip

Telephone

Alternate

Email

Do you know what type of photovoltaic (PV) system you would like?*

I would like a grid-connected system.
I would like a grid-connected system with backup.
I would like an off-grid system.
I'm unsure which type of system is best for me.

Please choose your primary reason for inquiring about a PV system.*

To reduce my electric bill and save money overall.
To reduce emissions from Utility power plants.
To promote the use of renewable energy.
To provide primary or backup power.
I have a different reason than those listed.

How much research have you done so far?*

I'm new to this and I'm not sure if PV is for me.
I'm new to this but I'm convinced that PV will work for me.
I've done the research and I'm ready to go forward.
I know what size system I need, I just need a price.

If you know what size system you need, please enter it here:

Example: 2500W or 2.5kW

How did you find Pure Power Solutions?

Referred by a friend or relative.
Newspaper or print advertisement.
Television advertisement.
Radio advertisement.
Home or Garden Show.
Search engine or web site.
Other

Please choose your electric Utility provider.

PG&E SMUD Roseville LADWP SDG&E Other

Do you have electric Utility bills for the last 12 months?*

Yes No They're around here somewhere.

*If possible, please fax electric bill copies to us immediately after completing this form.
We will need copies of your electric bills for system sizing and for rebates.
PG&E Customers can retrieve billing and usage information online by clicking here.

Please estimate your average monthly Summer electric bill.
   
$

Please estimate your average monthly Winter electric bill.
     
$

Please choose the location for mounting the PV panels.

Roof Mount Ground Mount New Structure/Trellis Other

Does this location receive direct sunlight between 9:00 AM and 4:00 PM?

Yes - All Day! No - There's Some Shade. Not Sure

Does this location have full exposure to the southern sky?

Yes No Not Sure

Please estimate the age of the home or building:

Years old.
* Enter "0" for planned new construction

Please estimate the square footage of the home or building:

Sq/Ft.

Is the building a one or two story structure?

One Story Two Story Other

If roof mount, please choose your roofing material.

Asphalt Shingles Tile - Concrete Tile - Clay/Adobe
Wood Shake Standing Seam Other / Not Sure

Estimated age of roof: Years.

Are you planning to re-roof?

Yes No Maybe

If you have any immediate questions or comments please enter them below.