Free Energy Audit

Welcome KRON 4 Viewers!

Please use the form below to tell us about your home so that we may better assist you with your comfort and energy-saving needs.

An asterisk (*) indicates a required field.

*Your Name:

*Address:

*City:

*State:

*Zip Code:

*Home Phone:

Office Phone:

Mobile Phone:

E-mail:

*Do you own the home?	YesNo

*Is your home a single or 2 story?

*Square footage of your home?

*Do you have an attic?	YesNo

*Is the attic accessible?	YesNo

Heater vents near the floor?	YesNo

Heater vents near the ceiling?	YesNo

Any vaulted ceilings?	YesNo

How many rooms are vaulted?

Is there a whole house fan?	YesNo

What year was your home built?

*Time frame for this project?

Comments / Questions