| Burley
Appliances |
| Customer Services |
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| Gas
Fitters / Installers |
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| All fields marked * are required. We need these in order to complete your request. |
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| Contact
& Qualification Form |
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| Name*
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| Address* : |
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| Postcode* : |
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| Telephone* : |
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| Fax : |
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| Mobile : |
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| Email : |
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| Post codes of
area covered : |
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| Radius covered
from base : |
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| CORGI Registration
Number : |
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| Propane/LPG
qualification : |
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| Do you have
a “Canary” : |
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| Do you install
new appliances to existing gas
points?* : |
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| If Yes to above
what is your normal charge for
this service : |
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| What
is your usual charge for service
work on gas appliances : |
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| Would you carry
out annual servicing of appliances?*
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| If
yes to the above what is your
normal charge for a gas appliance
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| Do you carry
out electrical repairs on appliances*
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| Are you a designated
service agent for any other
manufacture? : |
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| How
many CORGI registered engineers
does your company employ? : |
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