Note: All work is performed by Co-op members 
who are approved service providers for 
The Canadian Renovation Funding Program

To review information
about Pricing, click here

First Name:

Last:

Main Intersection:

Co-Owner's First Name:

Last:

and
Address:

City:

Best time range to call:
Province:
Between

and
Postal Code:
Home Phone:

Best Number:

Cell Phone:

Email Address:

How did you hear about us?

Talk 640 AM

Kijiji

Flyer

Retail Store:

Retail Code:

Other:

CFRB AM

Booklet

Home Advantage Club

The Jewel-88.5 F.M.

Private Referral

 Other

Billboard

TV Ad

Internet

Local Paper

Select Type of Work:

Approx Budget:
Job #1

Describe Other:

Job #2

Describe Other:

Please provide the following information:

Type of Home:

Detached

Semi-Detached

Townhouse

Condo

 Other

Approx. Age of Home:

Less than 10 Years

10-20

20-30

30-40

40-50

More than 50 yrs. old

Exterior:

Brick

Aluminum or Vinyl Siding

Combination
of both

Other

How old is kitchen?

1-2 years old

2-5 years old

5-10 years old

10-20 years old

Older than 20 years

Basement:

Is there any visible
water damage?

Is there an existing
separate entrance?

Yes

No
Yes No

Will you require financing?

yes

no

I'm not sure

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Best time range and phone number to call:

Comments

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