Smart Electric Vehicle (EV) Charging Program Application

Smart Electric Vehicle (EV) Charging Program Application
Please fill out the form below. A member of our program team will check your initial eligibility and be in touch regarding next steps.
Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Which best describes your position as a decision-maker for the installation of EV charging stations?

Property manager or ownerTenant or employee at property
Please provide your contact information:
Name*

First NameLast Name
Business or organization name*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Please provide contact information for the property manager or site owner:
Name*

First NameLast Name
Business or organization name*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address of Project Location

Street Address

Street Address Line 2

CityState

Zip Code