Please use the form for entering your new lead and appointment date/time.
Customer Preferred Language for Communication
*
English
Spanish
Primary Contact First Name
*
Primary Contact Last Name
*
Phone
*
Email
*
Address
*
City
*
(Add) Google Maps Image with Pin
What type of home do you live in?
*
Single Family Home
Condo/Townhome (HOA, Roof Ownership)
Multi-Family (2 or 3 Family Only)
Mobile Home (Double wide only)
Mounting type?
Main house, roof only
Main house + detached structure
On detached structure only
Ground mount only
Roof Type
Asphalt Shingle
Metal - Standing Seam
Metal - Corrugated
Rubber Membrane (Flat)
Other (Can't do)
Roof Age
Utility Provider
*
Eversource
National Grid
Unitil
Municipal
If credit is below 675, does the homeowner consent to a soft credit check
Yes
No
Secondary Contact Full Name
Additional Information
Type of Appointment
*
Online
In-Person
Appt. Date
*
Time for In-Person
In-Person - Please select time
10:00 AM
1:00 PM
4:00 PM
7:00 PM
9::00 AM (SAT ONLY)
12:00 PM (SAT ONLY)
3:00 PM (SAT ONLY)
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