Fireplace Showcase Recurring Annual Cleaning Request

This form is for enrolling in our recurring annual cleaning promotion. By filling out this form, you are requesting The Fireplace Showcase to schedule a yearly cleaning for you between the months of May and August. As a participant, you will receive a 10% discount on cleanings, service, and parts every year as long as you continue to participate.

After submitting this form, you will receive an automated response. Please note that there will be no communication from us until the period between May and August. If you require an immediate cleaning or service, please use our Service Request Form.

Please fill out the form below to request recurring annual cleaning. * are required fields.

First Name*

Last Name*

Email Address*

Cell Phone*

Home Phone

Address*

City*

State*

Zip*

Brand*

If other, enter brand name below:

If unknown or other, please upload a photo:

Model*

Serial Number