REQUEST FOR POOL MAINTENANCE

COMMERCIAL
COMPANY:

CONTACT :               TITLE:

RESIDENTIAL ADDRESS (POOL SITE)
LAST:                       FIRST:

ADDRESS (SUBDIVISION):

CITY:                  STATE:    ZIP:
      

MAILING ADDRESS
LAST:                       FIRST:

ADDRESS (SUBDIVISION):

CITY:                  STATE:    ZIP:
      

PHONE:           WORK:            CELL:               FAX:

E-MAIL ADDRESS:

Which manner would you prefer to be contacted?


Did Ladner's build or renovate this pool?
Y es
N o

Have you been a retail customer of Ladner's?
Y es
N o

Have you been a service customer of Ladner's?
Y es
N o

1) What kind of pool do you have?
Above Ground
In Ground
Indoor
Outdoor

2) Enter the square footage of the pool.


3) What is the pool made of?
Fiberglass
Tile
Vinyl Liner
Gunite
Aggregate Finish

4) Select the features of your pool.
Pool Heater
Electric Pool Cover
Solar Heating System
Filteration System
Manual Pool Cover

5) What kind of maintenance do you want?
One time cleaning
Winterization
Weekly Regular Maintenance Service
Only serving the New Orleans Metropolition area.
Payment must be made upon reciept check or credit card # on file.

COMMENTS AND CONCERNS: