RESIDENTIAL CONTACT FORM

Name:
Address: 
City: 
State: 
Zip Code: 
Home Number:   
Business Number:  
E-mail: * (required)

Number of Heating Systems?    
Gas Oil Heat Pump

Do you have a well pump?

Do you have septic pumps?

Do you have a sump pump?


Number of people living in the home including children?

In an outage, for how long would you need backup power?

Do you have a home office?

Do you have a media room? 

Which of the following items would you like to have on a back up system?

Telephone Alarm/Fire Fish tanks
Computer Garage Door Entertainment

What is the best time to contact you?

Would you like to receive a brochure?

How did you hear about Banner Power Company?
WTOP Radio Business Referral
WTOP Website Direct Mail
WCBS 880 AM Newspaper Ad
Internet Search Washington Spaces Magazine
Friend Other
Washington Gas  

Any questions/comments?

Privacy Notice:
The information obtained in this survey is considered confidential and will not be sold or transferred.


     

 

 

 



 

Banner’s battery-based power systems, now equipped with solar capabilities, are ideal for customers who want:

Reliable emergency backup
power during severe weather and power failures

Renewable energy technologies
to support emergency circuits and supplement their energy needs when the grid is operational

Power for remote properties not
connected to the utility company grid.