SOUL ENROLLMENT FORM

1. First Name

As it appears on the Electric account

2. Last Name

As it appears on the Electric account

3. Participant Account (Electric) Number

This is the account number on your electric bill. Only include the first 8 numbers. Please stop at the "-". For example if the account number is 12345678-90 you would only enter 12345678

4. Name of other person on the account (if applicable)

5. Home Phone Number

6. Mobile Phone Number

8. Additional Phone Number

9. Service Address

10. Service City

11. Service State

12. Service Zip Code

30240

30241

30261

13. Service County

14. Check the box if your mailing address is the same as the service address.

15. Mailing Address

If mailing address is different from property address, enter the mailing address below.

16. Mailing City

17. Mailing State

18. Mailing Zip Code

19. Email

Listing an email will allow our process to happen much faster. Email is used to receive your report and to esign documents.

20. Estimated Homes Sq Ft

Please enter the number of square feet of your home only. (numbers only field) Example - 1250 If unknown leave blank

21. What year was your home built?

22. Property Ownership

Own

Rent

27. How do you primarily cool your home?

Central Air

Window Units

Ceiling Fans

None

38. Is your home currently under renovation with missing ceilings/flooring/walls/windows

Yes

39. Respiratory Issue

Does anyone in your home have respiratory issues like asthma or on oxygen?

Yes

41. Indoor Pets

Cat

Dog

Cat and Dog

42. Health and Safety

Check the box if you have a leaky roof, mildew concerns, standing water or structural issues.

43. Do you have internet service in your home today?

Yes

44. Participation Reason

Which of the following reasons influenced you the most to participate in the SOUL Program?

45. Open Availability

Would you like to volunteer to be on our standby call list for cancellations and unexpected openings in order to get ahead of our assessment backlog? If so, please select from options below.

46. Comments

Enter any kind of special notes here

47. Release of Energy Usage

To establish a baseline from which to evaluate my home's potential for energy savings through the SOUL Program, you understand and consent to share past and present energy use from your home with all affiliated implementers, assessors, and contractors, to access solely and strictly in support of the program. By answering "Yes" below you are giving consent.

48. Attach Paper Intake Form if available

Drop your files here

49. Form entered into Smartsheet by

Enter your first and last name

Send me a copy of my responses

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