Seminetta Customer Inquiry Form

SEMINETTA'S CUSTOMER INQUIRY FORM

Today's Date:
Your Name:
Home Telephone:
Your E-Mail Address:
Street Address, City, State:
Do you need cleaning done?	yes
Do you need a painter?	yes
Briefly tell us what needs to be done:
The best time to contact you:
How did you find out about us?
Thank you kindly, Seminetta's Handyman Services, Inc.