ONLINE ORDER FORM
(work to be carried out in the next 21 days)
Sub 1
Sub 2
Line 3
Sub 1
Sub 2
Line 3
§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§
ONLINE ORDER FORM
(work to be carried out in the next 21 days)
Sub 1
Sub 2
Line 3
Sub 1
Sub 2
Line 3
§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§§
| OWNER / LANDLORD DETAILS * Full Name [text* customer-name 25/]
Primary Phone Number *
[tel* customer-phone1]
Alternative Phone Number
[tel* customer-phone2]
* E-mail * Address & Postcode – for invoice * SEND INVOICE TO (PLEASE TICK A BOX)
|
TENANT / PROPERTY DETAILS
If the details are the same as the property address then just enter ‘SAME’ or ‘N/A’ into the ‘required’ fields. * Name of contact (to arrange appointment with)
Primary Phone Number *
[tel* tenant-phone1]
Alternative Phone Number
[tel* tenant-phone2]
* Address & Postcode – for work * WHAT WORK IS REQUIRED? (PLEASE TICK A BOX)
NB. The price shown includes the main gas appliance (boiler) but additional gas appliances such as a fire, hob, cooker etc. are charged extra at £10 per appliance. The work will be completed ASAP subject to access to the property.
|
|||
|
SPECIAL INSTRUCTIONS
[textarea special-instructions 67×5 /] [response]
[captchac verify bg:#999999 size:l]
[captchar verify 4/]
[submit “Send”]
|
||||
