Work Order Request

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Below is the form we use to take all of our work order requests.  Knowing that your time is very valuable, we try to get ALL of the information needed to schedule as-soon-as possible.  It has always been our goal to fulfill the needs of our clients, and by having this completed information, we hope to continue to meet those needs.

Please have your client sign the contract and return to Gold Country Termite Control.  We will notify you and your client of the scheduled project date.

Please complete the following as much as possible.  There are two required fields to be filled out, they are, the Name and the Phone # of the person requesting the work.  If you are unable to complete any other fields, this information will be taken over the phone when we call you with the scheduled time.

Project Site Information

  Name(s) of Clients  
Street City
 Zip Phone


Closing Date Project site occupied?   
Electricity On?    Water On?   

Person Ordering Inspection

Name (required) Company
 Phone # (required) FAX #

E-Mail Address (required)


Access Information

(Name of Person to meet contractor, key under mat, owner to be home, etc.)

 Comments/Special Requests, etc.



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Last modified: March 29, 2006