Operations Form | Leadcentra

Agent & Client Information

Agent Name *

Client Name *

Customer Information

Customer's Name *

Phone Number *

10 digits only (e.g., 5555555555)

Backup Phone Number (Optional)

10 digits only (e.g., 5555555555)

Email Address (Optional)

Address Information

Street Address *

City *

State *

Zip Code *

5-digit zip code

Property Information

Single Family House? *

Yes No

Homeowner? *

Yes No

Roof Type *

How old is your roof? *

Trees blocking the sun on their roof? *

No, there is no trees blocking the sun Yes, there are some Trees blocking the sun

Utility & Financial Information

Utility Company / Electricity Provider *

Select a state to see top utility companies

Highest Electricity Bill *

$

Maximum: $4,000

Credit Score Above 650? *

Yes No

Annual Income Above 40K Per Year? *

Yes No

Appointment Details

Appointment Type *

Appointment Date *

Spouse Will be Available in Meeting? *

Yes No

Additional Notes

Notes (Optional)

Solar Appointment Form

Agent & Client Information

Customer Information

Address Information

Property Information

Utility & Financial Information

Appointment Details

Additional Notes

Good Job!