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* 1. First Name:

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* 2. Last Name:

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* 3. Address of Possible Project:

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* 4. Possible Project:

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* 5. Mailing Address if different from Possible Project address:

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* 6. Potential Project:

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* 7. Best phone number(s) you can be reached at:

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* 8. E-mail Address:

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* 9. How did you hear about Co-op Power?

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* 10. Please indicate what kind of system(s) you are interested in:

  Already purchased Would consider buying Not Sure I'd like more info No
Solar Hot Water
Neighbor to Neighbor Solar Hot Water
Solar Electric (PV)
Solar Hot Air
Stiebel-Eltron Heat Pump Water Heater
Stiebel-Eltron On Demand Water Heater

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* 11. An energy audit is the best first step you can take to ensure your renewable system is properly sized and most effective. The service is offered FREE through Mass Save and other programs. Have you had one?

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