JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Kilkeedy Energy Survey
This energy survey will allows the Kilkeedy Sustainable Energy Community to identify the energy solutions that fit the needs in Kilkeedy.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Eircode
*
Your answer
What year was your house/building built ? (to the nearest decade will be fine)
*
Your answer
What do you use for heating your home/building(s)?
(select as many as required)
.
Oil
Gas
Solid Fuel
Electricity (Heat-pump)
Electricity (non-heat-pump e.g. electric radiators)
Solar
Other
.
Oil
Gas
Solid Fuel
Electricity (Heat-pump)
Electricity (non-heat-pump e.g. electric radiators)
Solar
Other
Clear selection
What do you use for heating water ? (select as many as required)
.
Oil
Gas
Solid Fuel
Electricity (Heat-pump)
Electric immersion
Solar Thermal
Other
.
Oil
Gas
Solid Fuel
Electricity (Heat-pump)
Electric immersion
Solar Thermal
Other
What is your BER Rating ?
Choose
Don't have one yet
A1
A2
B1
B2
C1
C2
C3
D1
D2
D3
E
F
G
Please list the number and type of vehicles in your home ? (Leave empty if none)
1
2
3
More
Diesel car/van
Petrol Car/van
Hybrid car/van
Electric car/van
Electric bicycle
Bicycle
Motorbike
1
2
3
More
Diesel car/van
Petrol Car/van
Hybrid car/van
Electric car/van
Electric bicycle
Bicycle
Motorbike
Clear selection
How many people in the home use public transport for work,school or other reasons ?
(Leave empty if none)
1
2
3
More
Work
School
Other
1
2
3
More
Work
School
Other
Clear selection
Do you own your home or are you renting ?
*
Owner
Renting
Annual heating cost/usage
You can either put in the usage in liters or the cost in euros. Please use the € symbol if you give the cost so that we can tell the difference
Your answer
Annual Electricity Usage in kWh (units) or in euros
Please indicate whether it is kWh or €
Don't worry if you don't have these figures, you can still complete the rest of the survey.
Your answer
Do you have a smart-meter ?
Yes
No
Clear selection
Do you already have a Solar PV installation for producing electricity ?
Yes
No but interested
No, not interested right now
Clear selection
Would you be interested in having an energy survey done on your home/business ?
Yes
No
Clear selection
Name
Your answer
E-mail
Your answer
Phone Number
Your answer
Please say if you are happy to receive updates and information about the local energy plan for Kilkeedy by ticking YES
Yes
No
Clear selection
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
