Tell us about yourself: Items with an asterisk* must be entered to complete the form
* First and Last Name
* Street Name & Number
* City
* Zip
* Home Phone
Work Phone
* Your Email
* I am interested in an estimate for New RoofRoof CoatingOther Speciality Roof SystemRoof RepairRemodelingPaintingSheet RockFencingHardy Plank SidingOther (not specified above)
* I want to start this project As soon as possibleWithin 2-weeksWithin 4-weeksWithin 6-monthsbeyond 6-months
Tejas Roofing and Contracting* Referral: * Name:
IF YOU ARE INTERESTED IN A NEW ROOF SYSTEM
* (a) is your new roof leaking? yes no
* (b) how many layers of roofing is on your home/building now?One-layertwo-layersthree-layersI do not know
* (c) If this is storm damage, have you contacted our insurance company? yes no
* (d) if this is storm damage, has your insurance adjuster approved your loss? yes no
* (e) Are you considering upgrading your roof system? yes no
* (f) Are you interested in extended warranty coverage (material) offered by manufacturers? yes no
* My home is aone-storytwo-storysplit-level structure.
* What I want most in a contractor is
* Comments