Chicago Painters Inc.

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name: address: zip code city: daytime phone: evening phone: email address: date of job (roughly): interior exterior both IF INTERIOR number of total rooms to be painted 0 1 2 living room 0 1 2 3 4 5 6 7 8 9 10 11 12 number of bedrooms 0 1 2 0 1 2 3 4 5 6 dinning room number of bathrooms 0 1 0 1 2 3 4 5 kitchen basement 0 1 0 1 foyer hallways 0 1 0 1 2 3 4 5 solarium miscellaneous rooms 0 1 2 3 4 5 6 7 8 0 1 2 3 4 closets Are there any cracks in the walls or ceilings that need repair (if so describe below): Does any wallpaper need to be removed?: no yes no yes Are you a returning customer?: no yes Describe job in as much detail as possible: How did you hear about us? flyer friend google radio craigslist yahoo newspaper Ask.com other

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