Residential
Please fill out this form if you are interested in
remodeling or adding on to your home.
Name:
Spouse:
Address:
City:
State:
Zip:
Home #:
Work #:
Home Information:
Age of Home?
--Select One--
1 yr
2 yrs
3 yrs
4 yrs
5 yrs
6 yrs
7 yrs
8 yrs
9 yrs
10 yrs
11 yrs
12 yrs
13 yrs
14 yrs
15 yrs
16 yrs
17 yrs
18 yrs
19 yrs
20+ yrs
Home Value:
Brick or Siding?
--Select One--
Brick
Siding
Siding:
--Select One--
Wood
Vinyl
Age of Roof:
--Select One--
1 yr
2 yrs
3 yrs
4 yrs
5 yrs
6 yrs
7 yrs
8 yrs
9 yrs
10 yrs
11 yrs
12 yrs
13 yrs
14 yrs
15 yrs
16 yrs
17 yrs
18 yrs
19 yrs
20+ yrs
Windows:
--Select One--
Wood
Vinyl
Age of Windows:
--Select One--
1 yr
2 yrs
3 yrs
4 yrs
5 yrs
6 yrs
7 yrs
8 yrs
9 yrs
10 yrs
11 yrs
12 yrs
13 yrs
14 yrs
15 yrs
16 yrs
17 yrs
18 yrs
19 yrs
20+ yrs
Do you have a deck or porch?
--Select One--
Yes
No
Have you considered home additions?
--Select One--
Yes
No
Which additions have you considered? (check all that apply)
Sun Room
Fence
Family Room
Deck
Garage
Shed
Pool
Other
If other please explain:
Remodeling Information:
Have you considered remodeling?
--Select One--
Yes
No
If so, which of the following have you considered? (check all that apply)
Kitchen
Game Room
Bathroom
Closet
Basement
Other
If other please explain:
Contact Information:
Person to speak with?
Are you employed?
--Select One--
Yes
No
Where are you employed?
Where is spouse employed?
Best Time & Day to Call:
--Day--
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
--Time--
8:00 am
8:30 am
9:00 am
9:30 am
10:00 am
10:30 am
11:00 am
11:30 am
12:00 pm
12:30 pm
1:00 pm
1:30 pm
2:00 pm
2:30 pm
3:00 pm
3:30 pm
4:00 pm
4:30 pm
5:00 pm
5:30 pm
6:00 pm
6:30 pm
Comments: