(720) 315-9692

(720) 315-9692

Go Green Fundraiser

Sponsored by PRQ and Bear Creek High School

Do you own your home?

Yes, I own my home

No, I rent my home

Which student helped set up your appointment or referred you to this page?

Do you plan on living in your home for longer than 2 years

Yes

No

First Name

Last Name

Phone *

Street Address

City

Postal code

What is your average monthly Electric Bill?

$0 - $100

$101 - $150

$150 - $200

$201 - $300

$301 - $400

$401 - $500

$500+

Is your credit score 650 or higher?

Yes

No

How shaded is your roof?

Full sun

Partial shading

Heavily shaded

0%

Find out if you quality by taking our 30-second survey!

(555) 555-5555

(720) 315-9692