EV Infrastructure Project Partners Form

Please fill out this form if you want your organization's information listed on the EV Infrastructure Project Partners Directory. The Directory is a list of organizations with stated services and needs that interested parties can utilize to make partner connections for electric vehicle charging station projects.

DISCLAIMER: The Michigan Department of Environment, Great Lakes, and Energy (EGLE) does not necessarily constitute or imply its endorsement, recommendation, or favoring of organizations included in the Directory.

Question Title

* 1. Organization Information

Organization Name

Address

City

State Abbreviation

ZIP

Website

Question Title

* 2. Organization Contact Information

Contact Name

Email Address

Phone Number (xxx-xxx-xxxx)

Question Title

* 3. Organization Services

Charger Hardware Vendor

Charger Software Vendor

Consultant

Contractor

Electrician

Operation & Maintenance Provider

Owner

Site Host

Utility

None

Other (please specify)

Question Title

* 4. Organization Needs

Charger Hardware Vendor

Charger Software Vendor

Consultant

Contractor

Electrician

Operation & Maintenance Provider

Owner

Site Host

Utility

None

Other (please specify)

Question Title

* 5. Permissions

By submitting this form, you agree and consent to your information which you provide to the Michigan Department of Environment, Great Lakes, and Energy (EGLE) in this form being processed, collected, used, disclosed and/or retained by EGLE for the purpose of facilitating partner connections for the National Electric Vehicle Infrastructure Formula Program, Charge Up Michigan, and other similar programs.