Electrical Enquiry Form

Customer Electrical Quote / Work Request
Thank you for your recent enquiry for some electrical work.

To allow us to get a quote to you ASAP or determine if a site visit is required

Please take a few minutes to fill out this form ensuring to attach as many photos as possible.

This helps with accuracy and speed to enable us to get working on your job.

If for whatever reason you are not able to do this please let us know by calling ‭0405 656 357‬ or 8151 0471
Company name
Full Name*

First NameLast Name
Home / Compnay Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Installation Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Landline Number
Please enter a valid phone number.
Mobile Number*
Please enter a valid phone number.
Email*
Email address is required so we can send your digital quote/invoice & certificate of compliance on completion
How did you hear about us?*

Courtesy Card in letter boxFacebookFlyerGoogleGoogle MAPSInstagramJim'sReferral (friend, family member, co-worker)SignWebsiteWord of mouthOther (Please Specify)
Provide a detailed description ( list ) of what electrical jobs you require*
Upload relevant files & photos of work to be done . Please add any equipment you are supplying *

Up to maximum of 10 images can be uploaded
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Upload Photos of Meterbox , FUSE BOX , Electrical ciruits - Sub boards etc - Doors open so we can see all equipment*

Up to maximum of 10 images can be uploaded
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Property Structure*

Single storeyDouble storeyOthers (please specify)
Type of roofing*

Tin - FlatTin - PitchedTileOther (please specify)
Type of house/property*

Brick External - Gyrpock internalBrick External - Brick InternalWeatherboard external - Gyprock internalHebal external - Gyprock internalOther (please specify)
Do you have any safety switches?*

YesNo
Please attach photo of switchboard

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Are you wanting to:*

Book a jobRequest for quote
How would you like to finalise your account?

CashEFTVisa / Mastercard0% Interest Free Payment Plan
Please verify that you are human*
Should be Empty:

Customer Electrical Quote / Work Request