Energy Retrofit Programs Sign-Up
Cayoose Creek Indian Band
Contact Information
Household Contact
*
First Name
Last Name
Phone Number
Address
*
Elder Status
*
Yes, above 65
No
Roof Details
Roof Material
*
Asphalt Shingle
Metal Roof
Torch-on
Roof Age
1-5 Years
6-10 Years
+11 Years
Remaining roof life (years) before replacement, if known
Any roof issues (eg. leaks / other)
Heating System Details
Current Heating System(s)
*
Oil furnace
Propane furnace
Wood fire
Electric baseboard
Heat pump(s)
Acknowledgement - I understand home access will be required to complete a home evaluations and installation work for both the Solar Retrofit Program, and the Heat Pump Retrofit Program. I understand program Sign-Up via this form does not guarantee receiving solar panels or heat pump retrofits.
*
I confirm my interest in the Solar Retrofit Program
I confirm my interest in Battery backup as part of the above
I confirm my interest in the Heat Pump Retrofit Program
Submit
Should be Empty: