REGISTER - Crystal Fires

WE DO NOT SHARE DATA OR USE THIS INFORMATION APART FOR THE DETAILS OF YOUR FIRE FOR OUR OWN USE

If you are human, leave this field blank.

Benchmark

Serial number *

CONTROL TYPE *

appliance * appliance

Email Address *

NAME *

HOUSE NUMBER *

ADDRESS *

AREA *

CITY *

POSTCODE *

Phone Number

MOBILE Number

INSTALLATION DATE ------Day/Month/Year------23/02/2016

PROOF OF INSTALLATION MAY BE REQUIRED FOR INSPECTION BY OUR ENGINEERS

INSTALLER NAME *

INSTALLER GAS SAFE NUMBER *

GAS SAFE NOTIFICATION NUMBER

YOUR APPLIANCE INSTALLATION MUST BE NOTIFIED VIA GAS SAFE, SEE NOTIFICATIONS INFO ON OUR HOME PAGE. LEAVE BLANK IF YOU HAVE NOT RECEIVED YOUR GAS SAFE CERTIFICATE YET. HOWEVER, YOU MUST HAVE THE NOTIFICATION NUMBER AVAILABE WHEN REPORTING ANY FAULT

SHOP NAME *

SHOP ADDRESS

SHOP POSTCODE

Checkboxes *

BENCHMARK form filled in by installer (from the 1st march 2016 this must be checked)

Checkboxes *

I AGREE

I HAVE READ AND AGREE TO THE CRYSTAL FIRES TERMS AND CONDITIONS

Date