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Telephone Reference Check Form

Last Name

First Name

How did they hear of us:

E-Mail

Telephone

Company

Street Address

Suite #

City

State

Zip

What type of construction is the client's building?

Wood Frame

Pre Engineered

Masonry

Approximate Age of Home

Approximate Style of Home

How many floors does the building have?

1

2

3

More than 3

(how many)

Energy Audit

Private

HES

Weatherization

Yes

No

Area

(in ft²)

Max Working Height

Equipment area

Space-tight

Enough room

Solar Energy

Solar Thermal

Photovoltaic

Is a site visit required?

Yes

No

Main Heating Source

oil

natural gas

electric

propane

wood stove

Heat Type

Hot Water

Forced Hot Air

Steam

Retrofits

Lighting

Heating

Other

(what)

Customer interest level

A

B

C

Post proposal visit

A

B

C

UL/CL&P Acct #

Natural Gas Acct #

Other Site Issues

News | Updates | Events

Job training for 'green' jobs

AGE's sister company, the Institute of Environmental Management and Technology is now a Building Performance Institute Affiliate. IEMT now offers a variety of classes in weatherization of homes, industrial, commercial and institutional buildings. Contact us for more information or go to the IEMT home page.

AGE's Solar Store is opening soon. The store will feature solar hot water systems, photovoltaic energy systems and other solar supply goods. Contact us for a catalog and to join our mailing list.

AGE will offer commercial & industrial energy audits starting in November 2009.

AGE is currently approved to conduct Home Energy Solutions home check-ups for residential UI customers.