customer information
Name Date
Street Organization
City Telephone
State/Province Facsimile
Zip Code E-mail
Country    

project support requested
Anticipated delivery date
Additional linformation

site information
Number of sites –
Location (Nearest city, or long./lat.) –
Accessible by? ( Truck, 4 Wheel Drive, Helicopter, hiking, horse ) –
Will there be space to house solar electric components in equipment shelter? ( Yes / No ) –
Y N

solar module location
Location

Other

load information
Load #1
system voltage –
VAC VDC  
tolerance –
Min Max  
Daily Load - Amperage usage and hours of use per 24 hour day?
current (AMPs) –
for Hrs/day  
current (AMPs) –
for Hrs/day  
current (AMPs) –
for Hrs/day  
Load #2
system voltage –
VAC VDC  
tolerance –
Min Max  
Daily Load - Amperage usage and hours of use per 24 hour day?
current (AMPs) –
for Hrs/day  
current (AMPs) –
for Hrs/day  
current (AMPs) –
for Hrs/day  
Important - Does this system operate year round? ( Yes / No ) –
Y N

If no, please comment
Please use the following field for any comments that you may have.