Mendota Gas Stove Form

Mendota Process Form

Notes Mendota Gas Fireplace
Customer Information
Team Member Name:
Customer Name

First Name Last Name
Customer Email
example@example.com
Address of the Mendota Installation

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Design Choices

This section outlines the steps we go though to pick out the stove
Please select the following situation that best describes what you have currently?

Open fireplace that I want to insert something into Blank wall There is a an existing fireplace that I want to tear out & update We want the stove to be freestanding stove (not a Mendota)

Please add notes to issues that need special attention and issues not covered in the form so far:
Have we discussed the lead times, processes, deposit to get started, & final payment from sale to install for Mendota?

Yes No
By Signing this form you are acknowledging that the information you have given us is accurate to the best of your knowledge.

Clear
Should be Empty:

Mendota Process Form