Application Form2018-04-16T18:10:03+00:00

Application Form

Contact Us

APPLICATION FORM

Having your property MAINTAINED is as easy as  1,2,3.


STEP 1

NAME *
SURNAME *
EMAIL ADDRESS *
MOBILE NUMBER *

PROVINCE (SELECT): GautengWestern CapeLimpopoEastern CapeNorthern CapeNorth WestMpumalangaFree StateKwazulu Natal

TOWN *
SUBURB


STEP 2

PROPERTY TYPE *
ROOF TYPE *
NR OF BEDROOMS *
NR OF BATHROOMS *
NR OF GARAGES *
SINGLE OR DOUBLE STOREY *
PLASTER/FACEBRICK WALLS *
ESTIMATED HOUSE FLOOR SIZE *
ESTIMATED EARTH SIZE *
BUILDING STATE *


STEP 3

NR OF GEYSERS *
TYPE OF GEYSERS *
GEYSER 1 SIZE *
GEYSER 2 SIZE *
GEYSER 3 SIZE *
GEYSER 4 SIZE
GEYSER SITUATED *
KNOWN DAMAGES

SPECIFY GEYSER DAMAGE


*** OPTIONAL - CLICK TO UPLOAD PHOTOS OF PROPERTY (UP TO SIX - Max 2Mb each) PDF | JPG | PNG

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