Energy Consumption Benchmark Request Form

Organization Name

Contact Person Full Name

First NameLast Name

Contact Email Address

example@example.com

Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Facility Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Type of Facility

Facility Size (square meters)

Number of Occupants

Primary Energy Sources Used

Total Annual Energy Consumption (kWh or GJ)

Upload Recent Energy Bills or Consumption Reports (optional)

Main Purpose for Benchmarking Request

Other

Describe any major energy-consuming equipment or systems in your facility (e.g., HVAC, lighting, machinery)

Additional Comments or Special Requirements (optional)