[label Your Name (required)] [/label]
    [label Phone] [/label]
    [label Your Email (required)] [/label]
    [label Address (for roof simulation)] [/label]

    [label Monthly Electricity Spend (ZAR)] R 2000 [/label]

    [label Desired Independence (%)] 25% [/label]

    [label List Appliances?] [/label]
    [label Number of Geysers] [/label]
    [label Geyser Used at Sunrise?] [/label]
    [label Geyser Timer?] [/label]
    [label Number of Aircons] [/label]
    [label Aircon Type] [/label]
    [label Aircon Time] [/label]
    [label Aircon Hours Daily] [/label]
    [label Number of Deep Freezers] [/label]
    [label Number of TVs] [/label]
    [label Outdoor Pumps?] [/label]
    [label Pumps Used at Night?] [/label]

    [label Phase] [/label]
    [label Finance Option] [/label]
    [label Referral? (for free CoC)] [/label]

    [label Roof Material] [/label]
    [label Other Roof Material (if selected)] [/label]
    [label Roof Type] [/label]

    [label Loadshedding Hours (for backup)] [/label]

    [label Tariff Rate (/kWh)] [/label]
    [label Currency] [/label]

    [label Notes] [/label]