CLIENT INFORMATION FORM 

 NAME:
 

STREET ADDRESS:

 

CITY:   STATE:    ZIP CODE:

E-MAIL ADDRESS:
 

DAYTIME TELEPHONE NUMBER:

 EVENING TELEPHONE NUMBER:

CELL PHONE NUMBER: PAGER NUMBER:

FAX NUMBER:

 

 

PROJECT INFORMATION

JOB SITE ADDRESS:

 BUILDERS NAME:

 

SQ. FOOTAGE:    4-5K       5-6K      OVER 6K

 

ESTIMATED START DATE: ESTIMATED COMPLETE DATE:

 

  AREAS OF INTEREST 

CHECK ALL THAT APPLY

  SECURITY AND HOME AUTOMATION

SECURITY CAMERAS

ENERGY MANAGEMENT

LIGHTING CONTROL

PHONE SYSTEM

HOME OFFICE

MULTI-ROOM SOUND SYSTEM

SATELLITE SYSTEM

HOME THEATER

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