Name

Email Address

Address

Is Your Project: Is Your Project: Residential Commercial

What kind of services do you require? What kind of services do you require? Re-wiring Safety Switches Appliance Installation Powerpoint Installation/Repairs Lighting Installation/Repairs Ceiling Fans Installation/Repairs Heat lamps Installation/Repairs Smoke Alarm Installation Phone/Internet Cabling Switchboard Upgrades Safety Checks Fault Inspection other

If you chose other, please describe here:

When do you need the job done? When do you need the job done? Urgently This week Next couple of weeks Specific Date

If you entered specific date, please enter it here:

Do you have a budget in mind? Do you have a budget in mind? Yes No

Enter budget range here:

If your job needs a site visit, what day(s) would suit you? If your job needs a site visit, what day(s) would suit you? Strictly NO site visit required Weekdays Weekends Anytime

Any additional information on the project: