Lights and Chandeliers

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Name* This field is required.
First Name
Last Name
2
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Other
Country
3
Email* This field is required.
example@example.com
4
Phone Number* This field is required.
Please enter a valid phone number.
5
Please select all that you need installed* This field is required.
Ceiling fan
Chandelier
Fandelier
Light Fixture
Recessed Lights
6
Please list out how many Fans / Lights you need installed* This field is required.The more lights/fans you need installed, the more discounts you recieve
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7
What is your ceiling height?* This field is required.Please insert an approximate number in feet
8
When would you like to get this done?* This field is required.We can't guarantee the selected date/time will be confirmed but we can let you know the next availability we have from the selected date.
Date
Year
Month
Day
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Hour
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Minutes
PM
AM
PM
9
Is there a connection pre-wired for your fan/light?* This field is required.
YESNO
10
Please upload pictures of the type of fan/lights you need installed.* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
11
Need to upload pictures of your ceiling? please do so here.skip if you don't
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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12
Anything else you think we should know? Please share.
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