Sample Form

Questions marked by * are required.

Privacy statement

Empire Windows and Doors Inc.  Is committed to respecting the privacy of individuals and recognizes a need for the appropriate management and protection of any personal information that you agree to provide to us. We will not share your information with any third party outside of our organization, other than as necessary to fulfill your request.

1. First Name: *
                  
2. Last Name: *
3. E-mail: *
4. Street Address: *
5. Suite:
6. City: *
7. Postal Code:
8. Home Phone: *
9. Mobile Phone:
10. Business Phone:
11. Best time to call:
12. Products:
 
Empire Windows & Doors Inc.
Home Improvement

Tel.: (416) 493-7013
Fax: (416) 493-5407

www.empirewindows.ca
empirewindows@rogers.com