Intake Form
Please complete this form so we can assess eligibility for different grant opportunities and properly design a system tailored to your needs.
Contact Information
Contact Name
Your answer
Address of project site
Your answer
Email Address *
Your answer
Business Name
Your answer
Your answer
Phone Number *
Your answer
Project Specs
Electric Utility Company
Your answer
How much Electricity is used per year on average? (KWh or $)
Your answer
Tell us which clean energy technologies you are interested in?
What are your goals for this project
How much energy are you hoping to offset
Do you foresee any big changes in your energy load in the near future?
If yes Explain, how big of a change you are expecting and when you expect this change?
Your answer
Have any project bids been received?
What is the ideal timeline for completing the project?
Your answer
Where do you want to place the system?
What is your budget for this project?
Your answer
Does the applicant intend to pay for the project with cash or a loan?
Does the business or farm provide 50% or more of participants income?
Is there a residence on the property?
Additional comments
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This form was created inside of Lake County Resources Initiative. Report Abuse