Install EV Charger Request Form

The RADA has engaged with three Rochester-area preferred providers to install EV charging stations at personal residences or commercial properties. If you are interested in having one of the partners contact you regarding an installation, please fill out the information below and click “Submit”. You will be contacted promptly.

Your personal information will be safeguarded and used for this purpose only. It will not be sold or provided to any other company for their use.

Dealership Name

Name of person submitting request(Required)

First Last

Email address of person submitting request(Required)

Customer Name(Required)

First Last

Customer address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Customer Phone number(Required)

Customer email address(Required)

Year, Make & Model of the vehicle(Required)

Additional Comments

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