Ceiling/Chandelier Fan Installation Submission Form

1
Name* This field is required.Please fill out the fields below:
First Name
Last Name
2
Phone Number* This field is required.Please fill out the field below:
Please enter a valid phone number.
3
Email* This field is required.Please fill out the field below:
example@example.com
4
Address* This field is required.Please fill out the fields below:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
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Country
5
Appointment* This field is required.Select a date and time to schedule your ceiling fan installation appointment.
6
Do you need a ceiling fan or chandelier installed?* This field is required.Please select an option below:
Ceiling Fan
Chandelier
Both
7
How many ceiling fans do you need installed?* This field is required.Please select an option below:
1
2
3 or more
8
How many chandeliers do you need installed?* This field is required.Please select an option below:
1
2
3 or more
9
Please upload a photo of all ceiling fan or chandelier designs requesting to be installed.* This field is required.(This helps us understand and identify approximate installation timeframe.)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
10
Link to the ceiling fan or chandelier (if available):(Please provide a URL to the chandelier’s design or product page, not required)
11
What is the ceiling height where the ceiling fan(s) or chandelier(s) will be installed?* This field is required.(Select all that apply if installing multiple )
Standard ceiling (up to 8 feet)
High ceiling (9-12 feet)
Tall ceiling (13-20 feet)
12
Is there an existing junction/electrical box where the ceiling fan will or chandelier be installed?* This field is required.Please select an option below:
Yes
No
Unsure
13
Is there anything else we should know about your setup?(Include any special requirements or unique requests)
14
Bulbs/Celing Fan/Chandelier Defect Inspection

Please make sure to confirm that your ceiling fan/fans has ALL light bulbs included for a complete installation! Also, please be sure to inspect the ceiling fan/fans or chandeliers that you purchased very thoroughly for any damages or defects to avoid any problems that our installers could possibly encounter while assembling.
15
To confirm and book your ceiling fan installation, a 25% non-refundable deposit is required. Our team will reach out to confirm details, provide a final quote for approval, and send an invoice. The deposit can be paid via Zelle to Ingledoxent.payment@gmail.com
16
SignatureI understand that a 25% non-refundable deposit is required to confirm my booking.
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Bulbs/Celing Fan/Chandelier Defect Inspection