Full Name

Address of Charge Point Installation *

Eircode *

Phone *

Email *

Car Status

Have

Awaiting

N/A

If awaiting car, what is the expected date?

Vehicle type

Hybrid

Full Electric

N/A

Grant Status

Applied

To Apply

Approved

N/A

Age of Electrical Installation of the Property the charger is going to be fitted at

Pre 1990s

90s

2000 - Present