Request Electric Vehicle Wireless Charging

Drag & drop the pin at desired wireless charging locations.

REQUESTED CHARGING LOCATION(S)

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Is this your correct location?

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How many wirelss charging stations are needed here?

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Will this charging location be for private or public use? Please select one.

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What type of customer(s) will be using this charging location? Please select one or more.

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How many hours will this charging location be used?

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What type of electric vehicle(s) will be used here?

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Briefly tell us why this charging location is important to you:

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What describes you best?

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Do you own any electric vehicles?

How many vehicles?

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What is the best way to contact you?

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What is the best time to contact you?