ME boiler installation

Sales Form - Boiler Installation

Customer Name*
Prefix First Last
Customer Email
Landline number
Mobile number
Email*
Customer Date Of Birth
MM slash DD slash YYYY
Address Details
Address line 1*
Address line 2*
Town or City*
County*
Postcode*
Property type*
Customer Boiler Details
Boiler fuel type
Boiler type*
Boiler Make*
Boiler Age*
Boiler location
Flue exit location*
Preferred date for installation
MM slash DD slash YYYY
Employment
How many years have you been employeed*
Employment type*
Direct Debit Details
Bank name
Account Name
Sort Code
Account Number
AGENT MANDATORY SCRIPT :*
"Please confirm you're happy with warmbox and its financial partners performing credit checks on you. If successful your account manager will confirm the installation date and help you throughout the process, is that OK?"
Sales Info
Agent ID*
Office Name*

Why a new boiler is a great thing!

Flexible payment options
10-year warranty
FREE Boiler Service in year 2
Spread the payments from 1 to 10 years
0% APR available
FREE central heating system flush
Save money on your energy bills
Reduce your carbon footprint
Can be installed within 24 hours of approval

Save upto £340 a year

The Energy Saving Trust says that if you replace your old boiler with an A-rated boiler plus a new, modern set of heating controls, you could save up to £340 and 1,500kg of carbon monoxide a year.

Sales Form - Boiler Installation

Address Details

Customer Boiler Details

Employment

Direct Debit Details

Sales Info

Why a new boiler is a great thing!

Save upto £340 a year