SOUL ENROLLMENT FORM

As it appears on the Electric account

As it appears on the Electric account

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

7. Text Opt In*

Check yes if you would like to receive communications via text. Our communications do not contain advertising and your information is not shared. Data messaging rates may apply depending on your carrier.

LaGrange
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GA
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12. Service Zip Code*
Troup
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If mailing address is different from property address, enter the mailing address below.

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

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

22. Property Ownership*
23. Type of Home*

Mobile homes are not allowed in the program at this time.

24. Number of Occupants*
25. Number of Bedrooms*
26. How many stories is your home*
27. How do you primarily cool your home?*
28. What is your primary source of heat?*

Enter the average dollar amount you pay each year. Example:If you use $1,000 propane per year you only enter "1000". (You will need to provide annual fuel history documentation to substantiate this cost at time of house visit)

30. What is the primary type of heating equipment used to heat your home?*
31. How many central heating and cooling systems do you have?*
32. If you have a central heating and cooling system, is it operational?*
33. How many months ago did it stop working?*
34. How many years have you had your Central Heating and Cooling System?*
35. If you have a second heating source, what is this heating source?*
36. Secondary Heating Type*
37. From the list below, pick the one that is used the most.if it is on the same meter as your home*
38. Is your home currently under renovation with missing ceilings/flooring/walls/windows*
39. Respiratory Issue*

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

Tell us who has what respiratory issue.

41. Indoor Pets

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?*
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.

Enter any kind of special notes here

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.

Yes
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Enter your first and last name

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