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06/09
 
SOLAR ENERGY PROGRAM
RESIDENTIAL SOLAR ELECTRIC APPLICATION AND AGREEMENT
INSTRUCTIONS
This is the application for residential solar electric installations through the EarthWise Solar Energy Program. Thefollowing information must be included with the application: quote, site plan and three-line electrical diagram. Pleasesend the application via e-mail or mail to the address below.Mail: SRP EarthWise Solar EnergyResidential Solar Electric ProgramMail Stop PAB 355P.O. Box 52025Phoenix, AZ 85072-2025E-mail: EarthWiseSolar@srpnet.com
CUSTOMER
Name on SRP Account ___________________________________________ Daytime Phone # ________________ Spouse Name _________________________________________________ Evening Phone # ________________ System Location Address ________________________________________________________________________ City ____________________________________________ State ______________ Zip code ________________ Mailing Address (if different from system location) _____________________________________________________ City ____________________________________________ State ______________ Zip code ________________ Meter # (where the system will tie in) _________________ E-mail _______________________________________ Form completed by _______________________________________________ Phone _______________________ 
INSTALLER
 Company Name ____________________________________________________ Phone ____________________ Contact ________________________________________________________ Fax _________________________ E-mail Address ________________________________________________________________________________ Mailing Address _______________________________________________________________________________ City ____________________________________________ State ______________ Zip code ________________ License(s) Number:
C-11 __________________ 
L-11 __________________ 
K-11 ________________ 
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