Intake Form
Please complete this form so we can assess eligibility for different grant/funding opportunities.
Contact Information
Contact Name *
Your answer
Address or Projects Site
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Email Address *
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Business Name
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County
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Phone Number *
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Eligibility Questions
These questions will help determine eligibility for different grant programs
What businesses are located on the property (farm, home-based business, commercial/industrial business)?
Your answer
If the applicant is a farm, does the farm business provide over 50% of annual gross household income (gross farm receipts/total gross household income)? Note: This does not necessarily exclude you from eligibility
If the applicant is a business, how many full-time equivalent employees does it have average per year)?
Your answer
If the applicant is a business, what is the approximate annual gross revenue?
Your answer
How long has the farm or business been in operation?
Your answer
Is there a residence located on the property?
If so, is the residence on its own electricity meter?
Technology Questions
Tell us in which clean energy technologies you are interested?
Electric utility company:
Your answer
Major Electric loads on the property:
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How much electricity is used per year (kWh or $)?
Your answer
Natural gas utility company:
Your answer
What natural gas appliances are used on the property?
Your answer
How much natural gas is used per year (therms or $)?
Your answer
Is propane or other fuels used on the property?
If so, for what appliances?
Your answer
Have any project bids been received?
What is the ideal timeline for completing the project?
Your answer
Financial Questions
These questions do not influence eligibility, but may impact the economic viability of a project.
Does the applicant intend to pay for the project with cash or a loan?
Other information
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