Swemgat

Surname  *

Are you a returning customer?  Yes   No 

Street Address

Suburb  *

Tel/Cell. (daytime)  *

Cell.

E-mail  *

Who referred you? 1 : : 1 I am a happy returning customer  1 : : 2 Internet search  1 : : 3 A friend  1 : : 4 I saw a Swemgat vehicle  1 : : 5 Road ad  1 : : 6 A radio ad  1 : : 7 TV program  1 : : 8 Other 

City  *

What future day and time would suit you best for the installation?

Safety Net 1: Widest side of pool (metre)

Safety Net 1: My choice of net colour  Blue   Black 

Safety Net 1: Colour of plates to be mounted on paving  Black   Grey   Terracotta   Beige 

Safety Net 2: Widest side of pool (metre)

Safety Net 2: My choice of net colour  Blue   Black 

Safety Net 2: Colour of plates to be mounted on paving  Black   Grey   Terracotta   Beige 

Any special requirements or comments?

With self-closing gate?  Yes   No 

Height of fence  1.2m (standard)   1.3m   1.4m   1.45m 

What colour frame would you like for the fence?  Black   Green   Beige 

   

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