New Home Information Request

Please provide the following information and we'll contact you.
We will respect your information, keeping it confidential and not sharing it.

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* Name:

Mailing Address:    Town:    Postal Code:

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Home Phone:    Cell Phone:    Work Phone:

Email:

Brief description for new home requirements:


Location of property where work is to be done:


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Contact Information

Harvey and Theresa Poloyko
Box 962
Fort Qu'Appelle SK, S0G 1S0
Phone: (306) 332 5550
Cell: (306) 331 6963
E-mail: hpoloyko@sasktel.net

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