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2. 
4. A partnership of the Town of Southampton, Long Island Green Homes, PGI, GreenLogic and PeakPower LI.
6. Tell us what you're looking for - we'll help connect you with programs & savings.

   We value your privacy, in response to your inquiry you will only be contacted by Sustainable Southampton Staff and, depending on the boxes you checked, by the respective program providers.

8. I’m interested in

   1. Electrify Everything Livestream Access
   2. Electrify Everything Reserve my Seat
9. I'm interested in (Check any applicable box)

   1. Heating Pumps
   2. Energy Assessment
   3. Solar Energy
   4. Energy Storage
   5. REAP
   6. Community Solar
   7. Demand Response
11. First Name:*
12. Last Name:*
14. Email Address:*
15. Phone*
17. Street Address*
19. City:*
20. Zip Code:*
22. How did you hear about Sustainable Southampton?

    1. Social Media: FaceBook Instagram
    2. Email Solicitation
    3. Presentation
    4. Town Website
    5. Radio
    6. Newspaper
    7. Event
    8. Signs
    9. Word of Mouth
23. I'm a

    1. Homeowner
    2. Renter
    3. Business
    4. Other
24. Low-Middle Income (LMI) designated

    1. LMI eligible
26. Comments/Questions
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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