Please provide the following contact information (* Required):

Name*
Street Address*
City*
State*
Zip Code*
Phone*
E-mail*

(Optional:)

Did Artistic Illumination install your system?

Yes No

Are you interested in an extended service contract? (If yes, please select below)

Yes No

Service Frequency:

Once a Month
Every 2 Months
Every 3 Months
Every 6 Months
12 Months

Do you want us to replace every lamp in your lighting systems?

Yes No

Do you only want us to replace the light bulbs that are burned out?

Yes No

Do you have any broken fixtures that need to be repaired or replaced?

Yes No

Do you have any exposed cable that you want our technicians to cover and pin down?

Yes No

Do you want our technicians to trim back excessive landscape growth that covers the lights?

Yes No

Do you want our technicians to remove mineral deposits built up on fixture glass?

Yes No

Would you like us to leave you extra bulbs for self maintenance in between scheduled tune-ups?

Yes No

Would you be interested in energy saving sun tracking self adjusting time clock, with battery backup, that turns on the lights when dark?

Yes No

Are you interested in expanding your lighting system? (If Yes, Please Select Below)

Yes No

Check as many as apply:

Pathway Lighting
Moon/ Tree Lighting
Additional Up Lighting
Additional Shading against the house
Driveway Lighting
Around the Pool

If not listed, please describe: