GENERAL CONTACT INFO

First Name:

Last Name:

Email Address:

City/Town:

Daytime Phone Number:

Evening Phone Number:

Best Time To Contact You:

YOUR GARAGE DOOR

Size of Opening: high by

wide

**this is important information, so please measure with care**

Door Opener:

I have one I need one not required

Would you like an insulated garage door?

Yes No

Would you like windows in your new garage door?:

Yes No

Do you use your garage for:

workshop vehicle storage and vehicle other

IMPORTANT SELECTION CRITERIA FOR YOU

High R value
Color
Shock resistance
Appearance/aesthetics
Cost
Easy maintenance
Durability
Warranty
Safe operation

OTHER REQUIRED WORK:

Remove/dispose of existing door
Aluminum capping of existing door

OTHER COMMENTS/IMPORTANT POINTS TO MENTION:

HOW DID YOU HEAR ABOUT THE DOOR COMPANY?

TV
Radio
Magazine
Newspaper
Brochure
Home Show
Internet Search Engine
Another Website
Word of Mouth
Yellow Pages
I am a previous customer