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Dealership Information
Name of Car Dealership
(Required)
Test Dealership 1
Test Dealership 2
Test Dealership 3
Dealer Loan #
(Required)
For Customers paying Cash for EV Charger Installation, please put Cash in the Dealer Loan # box above.
Vehicle - Year, Make & Model
(Required)
Customer Information
First Name
(Required)
Last Name
(Required)
Phone
(Required)
Type
Mobile
Home
Phone
Type
Home
Mobile
Email
(Required)
Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Home or Condo
(Required)
Home
Condo
Homeowner or Renter
(Required)
Homeowner
Renter
If Renter - authorization from Landlord/Homeowner needed to complete installation
SUBMIT YOUR INFORMATION
Proposed Cost
$3,250
Proposed Cost
$3,500
Proposed Cost
$3,750
Proposed Cost
(Required)
Accept
Proposed Cost
$1770
“Not all Electrical Panels are capable of handling the addition of Car Charger Loads. Costs for Additional Work may be Required. If needed, additional Financing is available.”
Not all Electrical Panels are capable of handling the addition of Car Charger Loads. Costs for Additional Work may be Required. If needed, additional Financing is available.
(Required)
Accept
“All Installations are within 10 ft of Electrical Panel provided a clear pathway to Connection Point.”
All Installations are within 10 ft of Electrical Panel provided a clear pathway to Connection Point.
(Required)
Accept
Full Name
(Required)
