Information form,the Vertical Green Company

Request for information on vertical green walls

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Mr. / Ms. (Compulsory)

Initials / Christian Name

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Surname (Compulsory)

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Private/ Business (Compulsory)

What is your core business

Contact person

Visitors address

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Postal address (street) (Compulsory)

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House number (Compulsory)

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Postal code (Compulsory)

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City / Town / Village (Compulsory)

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County

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Country (Compulsory)

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Telephone number (Compulsory)

Mobile number

Fax

E-mail (Compulsory)

Website

Information about your vertical green wall

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Type of Wall (Compulsory)

Carrying Wall

Type of Buidling

Buidling is used for

Property Owned / Rented

Year of construction Buidling / Wall

Backing wall material

Total wall measurement (Length x Height)

Measurement of the required green wall (Length x Height)

Floor material under the wall

Water supply in close vacinity of green wall

Electricity supply in close vacinity of green wall

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Are there any particular items on/in the wall which need mentioning

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Your photo / sketch of the situation

Information on required plants and your choice for the frame

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Your choice of plants

Your frame choice

Required delivery time

Delivery time within

Additional remarks