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Required fields are designated with an asterisk *.
*Homeowner:
*Community	Choose Community... Glen Eagles Heather Ridge Wexford Village
*Address:
Lot:
Block:
*Home Phone:
Work Phone:
Cell Phone:
*Email:
Service Hours are between 7:30 AM to 4:30 PM Monday through Friday. What would be the time to reach you?
	Choose time from list 7:30 AM to 9 AM 9 AM to 10:30 AM 10:30 AM to 12 Noon Noon to 2 PM 2 Pm to 4:30 PM
Please list the items that are of concern in your home. Please be specific in describing location, sizes, colors, or dimensions, as applicable. Upon receipt of your request we will assign the appropriate subcontractors or service personnel to address the items on your request. Thank you.
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I authorize and accept responsibility for a Longford Homes Service Representative and/or the required subcontractors to enter my property in my absence to perform requested warranty service on the exterior of the house.
	Yes No