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Contact Information

This survey is for people interested in installing a solar hot water system. Co-op Power is a consumer-owned energy cooperative dedicated to building a just and sustainable future in New England and New York, wherever people have organized to bring Co-op Power to their community. So far, we have solar hot water installations going on across Massachusetts and Southern Vermont. Let us know if you'd like to organize a group to support installations in other areas. If you're in Massachusetts or Southern Vermont, you can sign up here to have Co-op Power do an installation for you! Fill in as much as you'd like. When you click on "Done" at the end of the survey, your information will be sent to us and we'll give you a call. We'll also get the information you enter when you click on "Exit the Survey" at the top of any page.

Please complete the contact information below.

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1. Name:

Name:

2. Mailing Address:

Mailing Address:

3. Street Address (if different):

Street Address (if different):

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4. City:

City:

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5. State:

State:

6. Zip Code:

Zip Code:

7. Day Phone:

Day Phone:

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8. Evening Phone:

Evening Phone:

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9. E-mail:

E-mail:

10. How do you prefer to be contacted?

How do you prefer to be contacted? day phone

evening phone

other

11. How did you hear about Co-op Power? (Please identify the person, organization, newspaper or radio station.)

How did you hear about Co-op Power? (Please identify the person, organization, newspaper or radio station.)

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