Illinois EnergyNet - New Organization Application

Organization Name:
Organization Type:
Workshop Preference:	None Scheduled
Contact
First Name:
Last Name:
Phone Number:	Format: xxx-xxx-xxxx Ext: *optional
Email Address:
Organization Financial Leader (if different than contact) What is this?
First Name:	*optional
Last Name:	*optional
Organization Address
Address Line 1:
Address Line 2:	*optional
City:
State:
Zip Code:
Building Targeted for Energy Improvement (if different than Organization)
Address Line 1:	*optional
Address Line 2:	*optional
City:	*optional
State:	*optional
Zip Code:	*optional
Target Building Size (square feet)
Exact:	*optional
Estimate:	*optional
Approximate Original Building Age (in years)

Approximate Most Recent Major Renovation/Addition (in years)

Primary Target Building Use

Questions/Comments

New Organization Application