Home Energy Score Assessor Interest and Qualification Reimbursement Form Survey

This form is intended to help OCPA identify professionals who may be interested in becoming Home Energy Score assessors, request consideration for limited qualification/training reimbursement, or be included on an OCPA interest list for future residential audit-related communications. This form is not a Home Energy Score certification, training enrollment, participation agreement, or contract with OCPA.

OCPA will use the information in this application to select participants and to administer and evaluate the program. If requested for program administration or the Home Energy Score assessor training and qualification process, OCPA may share identifiable application information with BayREN. OCPA will contact applicants about future opportunities only if they opt in through the applicable questions in Section 3.

Section 1: Applicant Information

1.Full Name:(Required.)

2.Company / Organization Name:
If self-employed or not affiliated with an organization, enter “Self-employed” or “Not applicable.”(Required.)

3.Job Title / Role:
If not applicable, enter “Not applicable.”(Required.)

4.Phone Number:(Required.)

5.Email Address:(Required.)

6.Company Website, if applicable:
If you do not have a company website, enter “Not applicable.”(Required.)

7.Business Address:
If you do not have a business address, enter “Not applicable.”(Required.)

8.How did you hear about the program?(Required.)