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Saturday (if possible)  Morning   Noon   Afternoon   Evening 

I use a second heating system which is a.. 1 : : Select One Select One  1 : : Not Applicable Not Applicable  1 : : Forced Air Furnace Forced Air Furnace  1 : : Heat Pump Heat Pump  1 : : Ground Water Heat Pump Ground Water Heat Pump  1 : : Hot Water Boiler Hot Water Boiler  1 : : Steam Boiler Steam Boiler 

My primary heating fuel is... 1 : : Select One Select One  1 : : Natural Gas Natural Gas  1 : : Propane (L.P.) Gas Propane (L.P.) Gas  1 : : Electricity Electricity  1 : : Fuel Oil Fuel Oil  1 : : Other Other 

I cool my home with a 1 : : Select One Select One  1 : : Not Applicable Not Applicable  1 : : Central Air Conditioning Central Air Conditioning  1 : : Window Air Conditioners Window Air Conditioners  1 : : Heat Pump Heat Pump 

I estimate the age of my heating system to be as well as cooling system. 1 : : Select One Select One  1 : : 1-5 years old 1-5 years old  1 : : 6-10 years old 6-10 years old  1 : : 11-15 years old 11-15 years old  1 : : 16-20 years old 16-20 years old  1 : : over 21 years old over 21 years old 

I estimate the age of my cooling system is...(Guess if you don't know) 1 : : Select One Select One  1 : : 1-5 years old 1-5 years old  1 : : 6-10 years old 6-10 years old  1 : : 11-15 years old 11-15 years old  1 : : 16-20 years old 16-20 years old  1 : : over 21 years old over 21 years old 

How did you hear of us? 1 : : Select One Select One  1 : : Previous Customer Previous Customer  1 : : Newspaper Advertisement Newspaper Advertisement  1 : : TV Advertisement TV Advertisement  1 : : Referred by others Referred by others  1 : : Yellow Pages Yellow Pages  1 : : Radio Advertisement Radio Advertisement  1 : : Sign on Service Truck Sign on Service Truck  1 : : Telemarketing Telemarketing  1 : : Billboard Billboard 

   

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