Type Of Purchase: Windows Doors Storm Doors
Install Date Purchase Date
First Name:
Last Name:
Installed Address:
City: Province:      Postal Code:
Home Phone No:
Email Address:

Would you like to receive e-mail communication from Polar Ray-O-Max Windows Canada regarding products and Services?     Yes    No

Are you a Repeat Customer                       Referral  Customer                    New  Customer

Are you satisfied with your Polar Experience     Yes    No

Additional Comments:  
 
Registration Certificate of Warranty Transfer
(This form is to be completed in the event that  you sell your home and transfer you warranty to new homeowners)
I hereby relinquish all claims under this warranty and certify that transfer of this warranty has been made within 60 days
Signature of Original Purchaser  _______________ Name of New Homeowner ________________
Transfer Date  _________________ Signature of New Homeowner ______________
Phone Number _________________ Email Address  _____________________