Surgery booking form

1. Customer Name*

2. Company Name (if applicable)*

3. Phone Number*

4. Email*

5. Site Name(s) and Location(s)*

6. Preferred days for surgery*

7. Preferred times

8. Are you a * Domestic Customer Commercial Customer ICP (Independent Connection Provider) or IDNO (Independent Distribution Network Operator) Community Energy Group Statutory body including Local Authority's / NHS / Police / Fire & Rescue

9. Area of interest* New Connection / Alter Existing Connection Generation (Solar/Wind) Low Carbon Technology (Electric Vehicle Charge Points / Heat Pumps) Unmetered Connection / Streetlighting Disconnections Diversions Local Electric Vehicle Infrastructure (LEVI)

To help us assess your connection requirements, we need to understand your load requirements and the type of electricity connection you require

Electricity Demand is a connection that allows the customer to imports electricity from the grid to meet energy requirements.

Electricity Generation is where electricity is produced (i.e via Wind, Solar). This can be exported back to the grid.

Please tick all that apply.

10. Load Requirements* Low Voltage (Up to 60kVA) Low Voltage (Between 61kVA - 300kVA) High Voltage (Between 301kVA -1MVA) Extra High Voltage (Over 1MVA) Generation (Up to 50kW) Generation (Between 51kW- 300kW) Generation (Between 301kW - 5MW) Generation (Over 5MW) Unknown

11. Brief outline of requirements* (Please provide as much information as possible as this will help us assign an expert with the required experience).

The data you provide will not be shared for sales or marketing purposes. We respect your privacy and will never share your information with third parties without your consent.

Information you share with us will be used by SP Electricity North West for the purposes stated above, and to continue improving the service we provide to our customers. From time to time, we carry out customer surveys and you may be contacted to take part.

You can unsubscribe from a list by clicking the unsubscribe link in any of the emails sent.

Read our Privacy policy for more information on how we handle your data.

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