Wiljan Electrical Inc.

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Client Request Form

Please fill out this form and press "Submit" at the end of the form. We will review , process and respond to your request within 48 hours.

Email *

Name *

Phone Number *

What is your preferred method of contact? *

Phone (verbal)

Phone (Text Message)

Other:

Required

In what city is the work being done at?

If the city was not listed above, in what town / city is the work being done at?

What is the postal code?

Optional. You may choose to type in the first 3 or all 6 characters of the postal code.

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This form was created inside of Wiljan Electrical Inc.