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Fill out the survey below to find out how to save more money on your energy costs.
Customer Survey
*Required Fields
*First Name
*Last Name
Address
City
State
Postal Code
*Phone
*E-mail Address
Customer No.
*Home Description
Single Family
Mobile/Modular Home
Vacation/Seasonal
Apartment/Duplex
Other
Other
*Water Heater Fuel
Electric
Natural Gas
Propane
Other
When was your water heater installed?
before 1985
1985-1990
1991-1995
1996-2000
after 2000
When was your heating system installed?
before 1975
1975-1980
1981-1985
1986-1990
1991-1995
1996-2000
after 2000
What is the age of the primary account holder?
Under 25
25-34
35-44
45-54
55-64
65 and Over
Do you own a computer?
Yes
No
Where do you have internet access?
Home
Work
Both
Do you rent or own your home?
Rent
Own
Do you operate a business out of your home?
Yes
No
Do you plan to build a house in the next three years?
Yes
No
What is your primary heating source in your home?
What are your favorite TV stations?
What are your favorite radio stations?
Who is your electric service provider?
How satisfied are you with your electric service provider?
-- Please select --
Very Satisfied
Satisfied
Dissatisfied
Do you recall hearing anything in the past 6 months about Touchstone Energy?
Yes
No
If so, where did you see or hear this information about Touchstone Energy?
Please give us your comments?