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Plate Glass Pricing Request form

Welcome to the Internet Glass Request and Order Form. For all your Glass needs, please fill out this form the best you can, and REMEMBER your are under no obligation to buy anything. Please include a detailed description and quantity amount of what you need. This will help us greatly. Once you are finished press the Submit Button below, a Glass shop nearest you will be contacted. After that depending how you choose to be reached, the Glass Provider will contact you regarding your inquiry. If you have an Auto Glass need please click the banner above you to return to our home page for all the other services we offer.  

What Glass Product are you in search of?
Clear Plate Bronze Plate Gray Plate Window Pane Mirror Safety Laminate
Tempered Acrylic Lexanne Plexi Insulated Window Bullet Proof
Mirrorpane Privacy Stain Glass

What  is the Thickness of the glass you need?
Don't Know 1/16 inch 1/8 inch 5/32 inch 3/16 inch 1/4 inch
3/8 inch 1/2 inch 5/8 inch 3/4 inch 

What Application will you be using the Glass for?
Table Top Decorative Mirror Bathroom Mirror Shelves Windows
Picture Frame Office Encasement Fireplace Cabinets Security
Shower Encasement Art Other

What Shape will the Product be?
Square Rectangle Triangle Oval Racetrack Oval
Circle Odd Shape Other

What is the approximate size that you require?
SIZE:  all we need is the approximate size.(example 15x30)
 

Now we need some Information to Identify You.
* is not a required field
FIRST NAME: 
LAST NAME: 
ADDRESS:* 
CITY:  STATE ZIP: 
COUNTRY: 
HOME TELEPHONE:* 
WORK TELEPHONE:* 
FAX TELEPHONE:*  
EMAIL ADDRESS: 

How will payment be handled?
I just need an estimate
Will be billing my Insurance
Will be Paying Myself
I am a Contractor
I am a Commercial Buyer
I am a Retail Buyer
Please ship me the part

How do we contact you with this Information?
Please call me at Home
Please call me a Work
Send me the info via E-mail
Please Fax me the Information

How did you come across our Web Page?
Don't Know Yahoo Excite Overture Google
AOL Lycos Link Exchange Banner Ad Other Search Engine

Please now make some special comments about your Glass Needs.

That would include quantity, and or additional sizes. The more descriptive

you are the better we can serve you.


Copyright 1996-2002 Hometown Glass Corporation, Internet Glass Network, Washingtonville NY 10992, all rights reserved
Last revised: December 19, 2012
 

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