Conversion van window replacement or repair questionnaire

To make your job as "GLASS EXPERT" easier, we have designed a page of information that you can fill out with what it is you need, and we can determine what material you will need to do it! Most importantly, if you have ANY questions, please drop us an e-mail, or call us on our toll-free number, and be sure and mention that you found us on the WEB!!!
If you don't need assistance with a window yet, but would like to receive our catalog, just fill in the name and address information at the bottom of this form, and a catalog will be sent immediately.

 

Would you like us to send you out a catalog?

Yes, but I still will fill out the checklist.
Yes, send the the catalog, but I'm going to skip the form. (Skip the checklist and go to the name and address info)

 

Year of vehicle?

Make of vehicle

Model of vehicle

Driver or passenger side?

Long wheel base?
YesNo

Outside dimensions in inches?

Do you need to correct anything....?

If possible, would you prefer to replace a portion of your window. If so, in the box to the right, check the portion of the window you would like to replace. Fixed top portion of window

Fixed lower portion of window

Slider portion of window

Shape of window...Does your window look like: 

This?

Or this?

Or even this???

Something completly different.

Describe it if you wish.

Window manufacturer

Other window manufacturer goes here,

Conversion company

Other conversion company goes here.

 

   

Is everything ok so far...if not ?

Does the frame have a chrome strip?

YesNo

Glass tempered by?
Any watermarks or initials?

Does the screen slide?YesNo

Does slider glass have screw on handle? YesNo

 



Your Name

Company Name

Mailing Address

City,

State, Zip

Phone Number (area code first!!)

If everything is corect, press "submit". Reset will clear the form.

Please be assured we will determine what window or replacement part you need, and will contact you as soon as possible! For even faster answers to your questions, you can call us on our toll free number, 1-800-637-8938, or e-mail us at [email protected]
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