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SPLASH RETAIL LEADS

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Product Delivery (Pond Kits, Rock, Etc.)

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Pond Clean-Outs

If filling out this form for a customer, include “Form filled out by [your name] at Splash” in the “What other information do we need to know?” section.

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Other Service

If filling out this form for a customer, include “Form filled out by [your name] at Splash” in the “What other information do we need to know?” section.

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PRODUCT DELIVERY

Name of person filling out this form *

Customer Name *

First

Last

Delivery Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Customer's Preferred Contact Method *

What product needs to be delivered? *

Does the customer understand that all rocks - including boulders - are a dump delivery? (Not delivered on pallets) *

Name and quantity of product to be delivered: *

Which rocks does the customer need? (Check all that apply)

Gravel (3/4")
1"-3" Rocks
5"-8" Rocks
Boulder Pallets (Dump delivery)
Other (Please specify below)

Where does the customer want their rocks dumped? *

All rocks - including boulders - are dump delivery.

How many scoops of 3/4" gravel? *

How many scoops of 1"-3"? *

How many scoops of 5"-8"? *

How many pallets of boulders? *

Has the customer tagged their boulders? *

Which pond kit did the customer purchase? *

Which waterfall kit did the customer purchase? *

When would the customer like their product delivered? *

Customer does not need to be home for kit delivery.

When would the customer like their product delivered? *

What time of day works best for the onsite consultation? *

We typically try to schedule for weekday mornings around 10 a.m. or afternoons around 3 p.m.

What weekday(s) is the customer available for consultation? *

Any day is fine
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
None

Any other requests for scheduling the delivery or consultation?

Have you confirmed that the customer's address is within the Splash Delivery Zone? *

Yes
No (Please explain below)

Not sure? Click here.

Has the customer paid for the order? *

Yes
No (Please explain below)

Has the customer tagged their boulders? *

Yes
No (Please explain below)

Other Notes:

717-751-2108 (Call or text)
1298 Toronita St., York, PA

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SPLASH RETAIL LEADS

CHOOSE A FORM:

Product Delivery (Pond Kits, Rock, Etc.)

Pond Clean-Outs

Other Service

PRODUCT DELIVERY

STORE

SERVICES

LEARNING CENTER

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