Calendar + Lead Entry

First Name *

Last Name *

Address *

City *

State *

Postal code *

Email *

Secondary Email

Phone *

Secondary Phone

Scope of Work *

Committed Customer *

Yes

No

If Yes above, how does customer plan to pay 1/3 deposit of total job estimate?

Spoke to LaPlante over phone and paid with CC

Plans to hand LaPlante a check at time of site visit

If not financing, will customer be paying for the remainder of the job cost total by check?

Yes

No

2-story residence? *

Yes

No

Age of roof? *

Are there any structural issues with the roof? *

Yes

No

Unknown

If Yes, would customer like us to obtain a quote from a roofer for repairs?

Yes

No

Type of Panel *

Panel Orientation *

Landscape

Portrait

Vaulted Ceilings *

Yes

No

Estimated % offset provided to customer. *

Sold at Price Per Watt (PPW) Before Financing *

Sold At PPW AFTER Financing *

Total contracted amount quoted before site visit modifications. *

Site visit date *

Upload Customer Utility Bill *

Upload 2nd Customer Utility Bill

Upload Mosaic screenshot *

Attic Access Picture *

Main Panel Picture Upload *

Sub or 2nd Panel Picture Upload

Meter Box Picture Upload (from stepped back position) *

Preliminary Design Upload *

Additional / Misc Pictures (Max 8)

Additional Notes

Submitting Rep Full Name *

Submitting Company *