energy efficient solutions, independent advice, insulationCovid-19

Curtain Bank Measurement Form  

 

Please complete the form below, including the curtain measurement section and contact Community Energy Action for an appointment on 0800 GET WARM (0800 438 9276). The Curtain Bank is a free service. However, our Curtain Bank is not fully funded and relies of further donations to keep going for future clients. We would like to encourage all those using the Curtain Bank to give to your ability. If you are experiencing serious financial hardship we do not want any donation and will be honoured to be able to help you. Please note that all donations over $5 are tax deductable. Donations can be made in cash to our donation box at the Curtain Bank or through our Givealittle page

We are very grateful for all donations, big and small.

 

Instead of filling in the form below, you can also download and print a measurement form here and send or email it to our office.

 

Please note the Curtain Bank operates on an appointment only basis.

* indicates required field
Name and Contact Details Customer
Name *
Street address *
Suburb / RD No. *
City / Town *
Postcode find your postcode *
Phone (main contact) *
Best time to call (during the day)
Phone (second option)
Email *
Details of Referring Organisation (only if required)
Refering Organisation
Referrer's Name
Referrer's Phone Number
Date of Referral
These curtains are for *
Do you have a health condition? *
Do you have a Community Services Card? *
Please advise of all the ethnicities in your household. *

 

Number of occupants by age group.

5 years and under *
6-17 years *
18-64 years *
65 years and over *

Please measure your windows exactly as show.  Do NOT add extra as this will limit your choices at the Curtain Bank, we will add on the extra lenght and gathers.

 

Track Width :  Measure your track.  If there is no track measure to the outside edges of the frame.

 

 

Drop Length : Measure from the top of the track to the bottom of the frame.  We will allow extra length for warmth.

 

What units are you using? *
Are you measuring to an existing track? *
Name of room | window
Width
Drop
Name of room | window
Width
Drop
Name of room | window
Width
Drop
Name of room | window
Width
Drop
Name of room | window
Width
Drop
Name of room | window
Width
Drop
Name of room | window
Width
Drop
Name of room | window
Width
Drop
Name of room | window
Width
Drop
Name of room | window
Width
Drop
Do you wish to make any additional comments / instructions?
 

 

Community Energy Action

0800 GET WARM (0800 438 9276)

+64 3 374 7222

info@cea.co.nz

299 Tuam Street

Christchurch

 

 

 

© Copyright 2017 Community Energy Action Charitable Trust

make an APPOINTMENT (householders)

make a REFERRAL (organisations)

form CURTAIN BANK (measurements)

 Receive Our Newsletter

Enter Details Here

 

 

Konstruk Content Management System