EV Charger Request Form
This form is for businesses only. If you would like an EV charger installed near your home, please provide that feedback
here
.
*
1.
Name:
(Required.)
2.
Relation to establishment:
Owner
Manager
Employee
*
3.
Email:
(Required.)
4.
Phone:
*
5.
Business or establishment name:
(Required.)
*
6.
Street address:
(Required.)
*
7.
Borough:
(Required.)
The Bronx
Brooklyn
Manhattan
Queens
Staten Island
8.
Phone number of business establishment:
9.
Additional comments: