Energy Smart Jax: Program Sign-Up
Complete this form to sign up for Energy Smart Jax, a pilot program implemented in partnership with City of Jacksonville, FOBT Pipeline Inc, and sponsored by United Sustainability Development Network. This program is providing  free in home energy audit toolkits,  free trainings, and energy-efficient Google Nest thermostat installations to help lower electricity bills for homeowners and renters that are eligible. 
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Email *
First Name *
Last Name
Street Address *
ZIP Code *
Occupation (Optional)
Housing Status *
Are  you or head of household interested in purchasing a home in the next 12 month?
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Annual Household Income *
Number of People Living in the Home *
What is the primary heat source in your home? *
Do you currently use a smart thermostat (e.g., Nest, ecobee, Honeywell) in your home? *
How important is reducing your monthly electricity bill to you?
Not important
Extremely important
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Preferred Contact Method? *
Required
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