First Name
*
Last Name
*
Phone
*
Email
*
Business
*
Address
*
City
*
Company Industry
Government/Council
Workplace
Fleet
Retail
Other
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Postal code
*
Are you the owner of the building that the business is located in?
Yes
No
Have you made an application in the previous grant rounds?
Yes
No
What Are Your Charging Needs?
AC Charging (7 - 22kW)
DC Charging (25 - 350kw)
Mixed (AC & DC)
Unsure
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What Type of Vehicles?
Cars
Vans
Trucks or Buses
Mixed
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How many chargers are you looking to have installed?
1 to 3
3 to 10
10+ a or a DC fast charger
Unsure
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Do you require billing systems to charge others for power?
Yes
No
Unsure
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If we require a site visit will someone be able to assist with showing the site and opening electrical boards?
*
Yes
No
Unsure
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Please add any additional information you feel may be useful to our team in preparing your quote.
Please provide the following photos to give us a clearer understanding of your site's electrical infrastructure: A view of your switchboard, focusing on the main switch and safety switch arrangements. Your Western Power meter number, if readily available. The planned location for the EV charger installation.
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