Charge Expression of Interest Form

* NAME:

* EMAIL:

* PHONE:

IF RELEVANT, WHICH ORGANISATION DO YOU REPRESENT?

TOTAL NO. OF CHARGEPOINTS (EXISTING):

TYPE (EXISTING):

7kW
22kW
50kW

ANY (EXISTING) GENERATION INCLUDED (e.g. PV Solar Panels/ Electrical Energy Storage)?

ARE YOU LOOKING TO EXPAND THIS? [If YES please provide details below]

TOTAL NO. OF CHARGEPOINTS (NEW):

TYPE (NEW):

7kW
22kW
50kW

ANY (NEW) GENERATION INCLUDED (e.g. PV Solar Panels/ Electrical Energy Storage)?

* POSTCODE

* ADDRESS LINE 1

* HAVE YOU EXPLORED YOUR CONNECTION OPTIONS (ie. NEW CONNECTION OR CONNECTING TO AN EXISTING SUPPLY)?

IF YOU WISH TO EXPLORE CONNECTING TO AN EXISTING SUPPLY, CAN YOU PROVIDE THE MPAN?

* ARE YOU THE LANDOWNER?

IF NOT, DO YOU HAVE PERMISSION FROM THE LANDOWNER?

IF A PLANNED INSTALLATION, DO YOU HAVE FUNDING SECURED?

IF NOT, PROVIDE DETAILS

PLANNED INSTALLATION DATE?

* ARE YOU WILLING TO ACCEPT A FLEXIBLE CONNECTION:

Please give further details below:

* WOULD YOU LIKE TO BE ADDED TO OUR STAKEHOLDER DATABASE TO BE KEPT UP TO DATE ON THE PROJECT?

Please refer to our Privacy Policy to understand how your data is treated once submitted via this form.