THE FORM BELOW IS ONLY FOR USE BY LANDSCAPE CURBERS.
IF YOU ARE A CONTRACTOR, BUT NOT IN THE CURBING/EDGING BUSINESS, PLEASE CONTACT LAMBERT USING THIS FORM.
Privacy Statement: Data you input is considered private and confidential. We do not sell or give information to any third party. Information is kept in our database only if needed for your account.
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THESE ARE REQUIRED FIELDS. This form will not process without this information!
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Your Name: (REQUIRED)
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Business Name:
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Email: (REQUIRED)
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Cell Phone:
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Business Phone:
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Home Phone:
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Phone number(s):
(Can list more than one, but note
here which is most important/primary)
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PHYSICAL BUSINESS ADDRESS:
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BILLING ADDRESS:
(if different than the physical address)
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SHIPPING ADDRESS:
(if different than the physical address)
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Is your business address your home address?
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YES
NO
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Is your shipping address your residential or commercial?
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RESIDENTIAL
COMMERCIAL
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Nearest large city:
(for locating freight terminal closest to you)
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Reason for completing this form:
(Choose subject and explain if necessary)
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Curbing Equipment type:
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Kwik Kerb customers:
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Type of color to be used:
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Referred by/how you heard of us:
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CUSTOMER ACCOUNT NUMBER:
(if you already have an account with us)
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COMMENTS:
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If your situation is not described above, or you have questions not answered in the Frequently Asked Questions inset, or any additional comments please note them.
Do NOT include credit card information on this form!
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Note: If the form is not complete, it will delay the review process!
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