Builder Company Name (required) Builder's Email (required) Builder Contact Name Phone Number Address of Builder City Postal Code Each builder MUST submit the following information on 4 customers. A builder may not list a customer that is an employee of their company. CHBA – MH will send the survey to the customers listed below; it is the responsibility of the builder to ensure the customer fills out and returns the questionnaire. All information will be held strictly confidential and released anonymously to the applicant if requested. ----- Customer #1 Name Address Postal Code Phone Number Cell Number Email Address Customer #2 Name Address Postal Code Phone Number Cell Number Email Address Customer #3 Name Address Postal Code Phone Number Cell Number Email Address Customer #4 Name Address Postal Code Phone Number Cell Number Email Address ------List of Trades----- Each builder MUST submit the following information on 6 major trades. A builder may not list a trade that is an employee of their company. CHBA – MH will send the survey to the trades listed below; it is the responsibility of the builder to ensure the trades fills out and returns the survey. All information will be held strictly confidential and released anonymously to the applicant if requested. Electrical Contractor Company Name Contact Name Address Postal Code Phone Number Cell Number Email Address Plumbing Contractor Company Name Contact Name Address Postal Code Phone Number Cell Number Email Address Heating Contractor Company Name Contact Name Address Postal Code Phone Number Cell Number Email Address Concrete Supplier Company Name Contact Name Address Postal Code Phone Number Cell Number Email Address Cabinet Supplier Company Name Contact Name Address Postal Code Phone Number Cell Number Email Address Truss Supplier Company Name Contact Name Address Postal Code Phone Number Cell Number Email Address To confirm your submission was successful, please contact CHBA - Medicine Hat's Executive Officer at eo(at)bildmedhat.com Δ