Hill Electric - Request A Quote

The following information will allow Hill Electric Solar Solutions to assess your needs more accurately. Please fill out the entire form as accurately and completely as you can.

First Name:	Last Name:
Street:
City:	State:	Zip:
Phone:	Email:
How did you here about Hill Electric?
Internet Radio Television Other
Will this installation be for:
Home Business Government School Farm Other
Please indicate your average monthly electric bill:
Under $100 $100-200 $201-300 $301-400 Over $400
Location of Installation:
Do you have at least 300 square feet of space (roof, patio covering, etc.)? Ideal locations should be shade free and facing south.
Yes No Don't Know
Roof Condition:
What type of condition is your roof in?
Good Fair Poor
Number of estimated years before your roof must be replaced?
Contact Information:
You would like to be contacted by:	Preferred Contact Time:
Phone Email
Additional Information or Comments:
We want to thank you for your interest in working with Hill Electric Solar Solutions. We look forward to hearing from you and providing you with the ultimate in customer service. We will contact you shortly with more in-depth information regarding your specific needs.