Fulkerson Plumbing

FULKERSON SERVICES INC.

1601 West Second Street
Roswell, NM 88201
Phone: 575-622-1600
Fax: 575-622-6030

Schedule Maintenance or a Free Estimate

Simply fill in the requested information in the form below and we`ll take care of the rest! As always thank you for choosing Fulkerson.

IMPORTANT!!! Please read before submitting your request.
DO NOT use this form for emergency or after hours service needs. Instead, call 575-622-1600.

Customer Information Please tell us about yourself

Name:
Address1:
Address2:
City:
State/Province:
Zip Code:
Daytime Phone:
Evening Phone:
E-Mail Address:

Type of call:

Heating Service Call
Air Conditioning Service Call
Plumbing Service Call
Duct Cleaning
Repair (non-emergency)
(If a repair call, please provide a brief description of the problem in the box below)

Appointment

Please provide us with 3 dates (mm/dd/yr) that you are available for an appointment. A customer service representative will contact you and we will do our best to accommodate your busy schedule.

What time of day would you prefer for your appointment?

8 - 11 am
11am - 2pm

For those of you who have extremely busy schedules or work full-time we offer:

2pm - 5pm
doesn't matter

What type of payment will you be using?

Cash Check Visa MasterCard Discover

How would you like our representative to contact you?

email phone

Other Information

Please tell us what prompted you to email us today and/or how you heard about us. Please select all that apply.

Television ad
Radio ad
Yellow Pages
Direct Mail
Word of Mouth
Our Trucks
Internet Search Engine
Hotlink from another website
I am a customer already
Other:

Comments/Special Requests:

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It may take a few moments but a confirmation form will be
displayed when your request has been processed. Thank you.

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