energy efficient solutions, independent advice, insulation

Yes, I'd like to make a free, no-obligation appointment or enquire about CEA services!

 

Fill in this form if you'd like to make a free, no-obligation appointment for insulation, heating, LED downlight replacement lighting or if you would like to make an appointment for one of our energy audits (a charge may apply). Organisations please fill in the referral form for organisations. For all other services/questions, please email us on info@cea.co.nz.

 

Please note: At present Community Energy Action works for customers in mid and north Canterbury (all Canterbury north of the Rangitata River) and in parts of the West Coast.

 

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** if you need have any issues completing this form, please call us

Name and Contact Details Customer (Installation Address)
Name *
Street address *
Suburb / RD No. *
City / Town *
Postcode find your postcode *
Phone (home) *
Best time to call (during the day)
Phone (work)
Phone (mobile)
Email *
Billing Address (if different from above)
Street Address / PO Box
Suburb / RD No.
City / Town
Contact / Support Person (only if required)
Name Support Person
Relationship to Customer
Phone (day)
I am *
Community Services Card *
In the property there is someone
In the property there is someone with a health condition *

If yes, please fill in the below to access health funding

Name of person *
Date of birth
GP
Enrolled Practice
I would like a quote for
Appointment *
How did you hear about us? *
If 'other', please specify
Comments
 

 

 

Community Energy Action

0800 GET WARM (0800 438 9276)

+64 3 374 7222

info@cea.co.nz

299 Tuam Street

Christchurch

 

 

© Copyright 2017 Community Energy Action Charitable Trust

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