KwadrO : Request for quotation without engagement

Name*:

First Name *:

Street + house number *:

Postal Code*:

Residence*:

e-mail:

Phone / GSM*:

You can join me best as of O’clock

We will build renovate in (village/town) and plan (number) windows and (number) doors.

Our construction plans are to occur within a period of

1 to 3 months
3 to 6 months
6 to 12 months
Longer than 12 months
Not yet determined

We want to be contacted without engagement by the KwadrO showroom in: [Make your choice *] Brasschaat Bree Diest Gent Herentals Ninove Rumst Schilde Tongeren Vilvoorde Waasland

How did you get to our website : [Make your choice] Radio TV Golden Pages : 1207 Golden Pages : paper guide Golden Pages : internet KwadrO-leaflet in my letterbox Architect Friends and/or family KwadrO-building sign boards Advertisements in newspaper or magazine Internet Fair Previous purchase Others

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Use a score between 1 and 5, whereas 5 stands for excellent and 1 is bad. If you have no opinion, leave the question open.