Product Claim Form: Solar Blanket

Product Details
In order to process your claim please provide as much information about the size of your solar blanket as possible.
Shape:
Size length (ft):
Size length (in):
Size width (ft):
Size width (in):
Warranty:


Your contact information
Title:
First Name
Last Name
Your Email
Phone Number
Fax Number
Address 1:
Address 2:
City:
State/Province:
Zip/Postal:
Country:


Claim Info
Purchased from:
Date of Purchase yyyy-mm-dd
Purchase Price
City:
State/Province:
Reason for claim: