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Thank You for Your Interest in Heat Siphon! - The Most Cost Effective Pool Heater Made!
Please complete the form below and click the "Submit " button at the bottom of the page. You will receive a full color brochure by mail within a few days.
(No information will be released or used in any way without your express permission)
Assoc. -Group Name Owner Type: Select Owner Type Private Home Condominium Apartment Hotel/Motel Resort Mobile Home Park Public Pool Dealer Unit Industrial Country Club School Spa/Health Club Aquarium Other
*First Name / Middle Initial / *Last:Name:
*Address :
*City/ST/ZIP: Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Mississippi Missouri Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Select State
*Work Phone: *Home Phone: FAX:
*E-mail: Birthday Month / Day / Year
Occupation: Annual Household Income: Select Income Range Less Than $40,000 $41,000 to $50,000 $51,000 to $75,000 $76,000 to $100,000 $100,000 to $150,000 Over $150,000
For Pool Owners Outside The United States:
Country / Province / Postal Code: Select Country United States Canada Mexico Albania Algeria American Samoa Andorra Angola Anguilla Antigua/Barbuda Argentina Armenia Aruba Ashmore/Cartier Islands Australia Austria Azerbaijan Bahamas, The Bahrain Baker Island Bangladesh Barbados Bassas Da India Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Clipperton Island Cocos Islands Colombia Comoros Congo, Democratic Republic Of The Congo, Republic Of The Cook Islands Coral Sea Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Europa Island Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia, The Georgia Germany Ghana Gibraltar Glorioso Islands Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island/Mcdonald Islands Honduras Hong Kong Howland Island Hungary Iceland India Indonesia Iran Ireland Israel Italy Jamaica Jan Mayen Japan Jarvis Island Jersey Johnston Atoll Jordan Juan De Nova Island Kazakhstan Kenya Kingman Reef Kiribati Korea, South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Man, Isle Of Marshall Islands Martinique Mauritania Mauritius Mayotte Micronesia Midway Islands Moldova Monaco Mongolia Montserrat Morocco Mozambique Namibia Nauru Navassa Island Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palmyra Atoll Panama Papua New Guinea Paracel Islands Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts/Nevis Saint Lucia Saint Pierre/Miquelon Saint Vincent/The Grenadines Samoa San Marino Sao Tome/Principe Saudi Arabia Senegal Serbia/Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/The South Sandwich Islands Spain Spratly Islands Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad/Tobago Tromelin Island Tunisia Turkey Turkmenistan Turks/Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands Wake Island Wallis/Futuna Yemen Zambia Zimbabwe / /
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THANK YOU FOR YOUR INTEREST IN HEAT SIPHON SWIMMING POOL HEATERS
The Following Information is NOT Necessary to Receive Your Brochure, but it will help us to recommend to you the most appropriate Heat Siphon Model and Size.
Again No information will be released or used in any way without your express permission
1st Time Pool / Spa Heater Owner Replacement of Existing Heater Adding to Existing Heater
WHY ARE YOU CONSIDERING HEAT SIPHON?
Brand Reputation Service Reputation Friend Recommended Installer Recommended My Own Research
Price Warranty Corrosion Resistance Efficiency Quality
SYSTEM INFORMATION
Type of System:
Pool Spa Pool /Spa Combo
Residential Commercial
Outdoor Indoor
Type of Pool/Spa: Please Select All that Apply
Vinyl Liner Concrete Fiberglass
Inground Above-ground
Domed Screened
Pool /Spa Sizes:
Pool Surface Area:
Sq Ft Sq M
Spa Surface Area: Use Pool Units
Pool Volume:
Gallons Liters
Spa Volume: Use Pool Units
Pool/ Spa Age:
Pick Age (yrs) New 1 yr 2 yrs 3 yrs 4 yrs 5 yrs 6 yrs 7 yrs 8 yrs 9 yrs 10 yrs 15 yrs 20 yrs Over 20 yrs
Pool/ Spa Cost:
Select Pool/Spa Cost Less Than $5,000 $5,000 to $6,000 $6,000 to $7,000 $7,000 to $8,000 $8,000 to $9,000 $9,000 to $10,000 $10,000 to $12,000 $12,000 to $15,000 $15,000 to $17,500 $17,500 to $20,000 $20,000 to $25,000 $25,000 to $30,000 $30,000 to $40,000 Over $40,000
How Did You FIRST Hear About Heat Siphon?
Heat Siphon Owner Pool Builder Pool Serviceman Pool Supply Co.
A/C Contractor Solar Contractor Friend Phone Book
Internet TV Magazine Radio
Mailer Newspaper E-mail Other
YES, Please Have a Factory Salesperson Call Me YES, Please Find a Local Dealer I may Contact YES, Please Send Me MORE INFO Keep me on your mailing list for future reference
