She Nailed It - Fee-For-Service Repairs New Customer Registration Form

She Nailed It - Fee-For-Service Repairs New Customer Registration Form
Customer Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Phone Number*
Format: (000) 000-0000.
Property Owner's Name*

First NameLast Name
Property Owner's Phone Number*
undefinedFormat: (000) 000-0000.
Property Owner's E-mail
example@example.com
Are these repairs for insurance purposes?*

YesNo
Days Available for Walk-Thru*

MondayTuesdayWednesdayThursdayFriday
Times For Walk-Thru*

9:00 AM - 11:00 AM11:00 AM - 1:00 PM1:00 PM - 3:00 PM
Service*

PaintingDrywall RepairHandrails/Grab BarsFaucet Repair/ReplacentElectrical Outlet ReplacementLight Fixture Installation/ReplacementCeiling Fan InstallationStorm Door InstallationPowerwashing
We offer sliding-scale pricing based on household size and income. After you submit this form, we’ll contact you separately to request proof of income to confirm eligibility.

I would like to be provided sliding scale pricing.
Would you like to add a donation to support sliding-scale families? Your optional donation will be determined and included on your service invoice and supports families using our sliding scale.*

Yes, I will add a donation to my invoiceNo, not today
Do you have repairs/renovations beyond those listed above? Please describe here ( we can take on a limited amount of larger scope projects a year), a team member will contact you about next steps:
Do You Have Pets?*

YesNo
Permission to Take and Share Before/After Photos (Unidentifiable)?*

YesNo
Our Process:

1. We review your request and contact you to schedule a walkthrough.

2. A team member will confirm your walkthrough appointment via email or phone.

3. We conduct the walkthrough with the homeowner or a designated representative.

4. A detailed quote will be provided within 48 hours.

5. Once the estimate is approved, we will sign contract and schedule work.

Thank you for using this service that helps employ women in the skilled trades. Let us know if you have any questions, we look forward to helping with your repairs!
Should be Empty: