Service Request

Service Request

Use this form to request a service call. We check our e-mail frequently and will respond to your request shortly. Thank you!

Contact Person:

Company Name:

Customer ID:

Street Address:

City:

Phone Number:

Work Phone:

E-mail Address:

Service Request
Description:

Describe your service request:

Date Wanted:

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© 2000 by Gordon Water Systems. All Rights Reserved.
618 E. Crosstown Parkway • Kalamazoo, MI 49001
Phone (Toll-Free): 1-800-Water-68 • Kalamazoo: (269) 382-0068 • Grand Rapids: (616) 776-3800
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