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Unit 35 Wolseley Court,
Staffordshire Technology Park,
Stafford
ST18 0GA

      Name

      Address

      Contact Number

      Email

    Does your vehicle qualify for the OZEV grant

    YesNO

    Have you taken delivery of your electric vehicle or are you waiting on delivery

    YesNO

    Preferred EV charge point brand

    Make & model of EV / Hybrid

    If other was chosen please specify the make & model of your vehicle

    Un-tethered or Tethered

    Un-Tethered is a socket and has no fixed lead and plug, you need your own lead for this. Tethered has a fixed lead and plug which is coiled up around or next to the unit when not in use

    Un-TetheredTethered

    Kw output of the EV charging point

    7Kw3Kw

    Approximate distance from the consumer unit (fuse board) to the proposed location of the EV charge point

    Do you have a solar PV system installed or intend on having solar PV in the future

    YESIntend toNO

    Other relevant information