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:
Email:
Phone Number:
Fax Number:
Address 1:
Address 2:
City:
Zip/Postal:



State/Province:



Country:


CLAIM INFO
Purchased from:



Date of Purchase (yyyy-mm-dd)
Purchase Price:
City:



State/Province:
Reason for claim: