Answer the questions below to nominate for Women Power Pilot

1 Million Women is teaming up with the City of Sydney to pilot our 'Women Power' network. Our aim is to make saving energy 'sexy' and engaging - for the benefit of our household budgets, the wider economy and the planet.

So we’re after 10 fantastic women volunteers to have equipment installed in their homes to become Women Power pilot sites. Participants will be supported to become experts on electricity use in their own homes. They will learn how to monitor it, understand it and most importantly save it.

The successful volunteers will need to be available to attend two – three training workshops, report on their energy-saving experiences, participate in our 'Women Power' public event in October, and possibly take part in media engagements - all over a six month period from July 2013.

In return, participants will receive state-of-the-art energy management equipment and software worth over $400 per household free of charge, and will be able to keep this after the pilot is completed. You will also receive support that could help you save hundreds of dollars a year off electricity bills for your household.

To volunteer you need to be a member of 1 Million Women living within the City of Sydney local government area (for more details click here ). Our project team will select the 10 successful volunteers to create a strong, diverse and enthusiastic set of participants.

If you'd like to volunteer please answer all of the questions below.

NOTE: Short-listed applicants will be contacted by email and we will announce final outcomes via the 1 Million Women website and Facebook when the 10 successful volunteers have been selected. I Million Women’s participant selection will be final.

CONFIDENTIALITY: Information you provide for this questionnaire will be kept confidential to our project team and will not be used for any other purpose than selecting our 10 Women Power pilot participants.

For more information about City of Sydney go to: http://www.cityofsydney.nsw.gov.au/

For more information about Green Villages go to: http://www.greenvillages.com.au/

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* 1. Tell us in about 50 words why you would like to be selected as one of our 10 Women Power pioneers and what you will bring to the pilot project?

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* 2. What is your full name (as an applicant you must be a women head or co-head of household aged 18 years plus who lives within the City of Sydney and is a member of 1 Million Women)?

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* 3. What is the full address of your residence? (Must be located within the City of Sydney local government area.)

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* 4. What is your usual occupation?

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* 5. What is your email address and mobile or other telephone number for us to use to contact you?

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* 6. What kind of dwelling do you live in?

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* 7. How many people are living in the dwelling?

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* 8. What is the ownership status of your dwelling?

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* 9. Do you control direct access to your electricity meter box?

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* 10. Do you have any (or all) of the following technology items?

  Yes No
Wireless router (broadband)
Home computer (PC or laptop)
Apple iPhone
Apple iPad
Rooftop solar panels
Airconditioning
Swimming pool

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* 11. Do you have copies of recent electricity bills for your dwelling?

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* 12. Have you already taken any of the following actions aimed at managing and reducing electricity consumption in your home?

  Yes No
Installed an in-home display device showing electricity use in real time
Had a professional home energy audit conducted for your home
Installed energy saving equipment such as efficient lighting or energy-star rated appliances

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* 13. If you are selected as a successful volunteer, will you be able to agree to the following actions to ensure the success of the 'Women Power' pilot project? (NOTE: Successful applicants for the 10 'Women Power pilot' opportunities will receive a detailed briefing on what is required of them and will be asked to sign a Participation Agreement in exchange for the valuable equipment and service they will receive.)

  Yes No
Provide us with a digital photo of your electricity meter box
Facilitate access to your electricity meter box for equipment installation
Provide log-in and password information for your wireless router to allow connection with the energy management equipment
Participate in 3 x 2-hour workshops for the participants
Agree to share your private electricity use data with other participants and the project team
Agree to participate as a 1 Million Women 'Women Power champion' at one major public event?
Agree to be involved in media engagement for the 'Women Power' pilot?

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