Home Energy Audit & Weatherization Request Form

"*" indicates required fields

URL

This field is for validation purposes and should be left unchanged.

Member Name*

First Last

Service Address*

Street Address Address Line 2 City State ZIP Code

Mailing Address*

Same as service address

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Home Type*

Site Built

Manufactured

Year Built

The site built home must have been built before 1992. The Oregon Building Code required site-built homes built in and after 1992 to be weatherized at the time of construction.

Water Heating System Type*

Heating System Type*

The home must be heated electrically as the primary heat source to qualify.

Combustion Appliance*

Home Square Footage*

Please enter a number from 1 to 10000.