Submit an appointment

Qualify the lead, attach the utility bill, and send it to the rep pool.

Submitting as

Customer

Who's the appointment with.

First name*

Required.

Last name*

Required.

Street address*

Required.

City*

Required.

State*

Required.

ZIP*

5 digits.

Phone*

Enter a valid phone number.

Email*

Enter a valid email.

Utility provider*

Required.

When the rep should show up, and how.

Appointment type*

Date*

Required.

Time*

Required.

Answer all three before submitting.

Is this the homeowner?*

Are they on a low-income electricity plan?*

Is their monthly electric bill over $150?*

Photo of a recent bill, optional.

Tap to take or upload a photo

JPEG or PNG

Anything the rep should know before showing up.

Reps get an SMS + email the moment you submit. First to claim it gets the appointment.

Hello, World!