EV Survey

Member Information

Name:

Account Number:

Email Address:

Phone Number:

Service Address:

Mailing Address:

Vehicle Information

Age of Driver:

Average Miles Driven Per Week:

Make & Model of EV:

Date of Purchase:

Do you currently have a charger?

Yes

No

How often do you charge your EV?

Where is the charger located?

Is there a 240V dedicated circuit-NEMA 14-50 plug?

Yes

No

Are cables able to reach the EV with slack?

Yes

No

Would you be interested in participating in a paid pilot program for 25 DEMCO members to share EV charging data?

Yes

No