Project Registration Form
Phone: 1-800-257-6390 Fax: 1-616-396-8022
E-Mail: custcare@fleetwoodgroup.com
After completing the information below, click on "Submit Data" button to submit your project registration.
If you prefer, this form may be printed, completed and faxed to the fax number above.
*
Required fields
To:
Drew Ericks
Connie Beckman
Jerry Kortman
Kris Riemersma
Other
From:
Your Email
*
:
Date:
Dealer:
Sales Person:
Phone #:
Fax #:
Job Name:
Contact Name:
Contact Phone #:
City:
State:
Zip Code:
Qty
Model #
Description
Item #1:
Item #2:
Item #3:
Item #4:
Item #5:
Item #6:
Anticipated Delivery Month:
January
February
March
April
May
June
July
August
September
October
November
December
Unknown
Anticipated Delivery Year:
2006
2007
2008
Unknown
Will the job go out for bid?:
Yes or
No
Bid Open Date:
Comments:
Click here to exit without submitting