If you are a resident of the following areas and would like a free estimate, please complete the following form and a MACWEST representative will contact you shortly to make the necessary arrangements.

Canada	United States
Easter Townships (Quebec) Laurentians (Quebec) Montreal & Surrounding Areas (Quebec) Cornwall & Surrounding Areas (Ontario)	Upstate Vermont (Burlington & Surrounding Areas and North to Canadian border) New York State (North of Albany)

Please place a check mark in the appropriate boxes below, then complete your name and address and click "Submit".

Type Of Structure
	Bungalow
	Mansard Wall
	Commercial / Industrial Cladding
	Canadienne
	Cottage
	A-Frame
	Swiss Chalet
	Barn
	Garage
	New Construction
	Other
Existing Roofing Material
	New Construction - Does Not Apply
	Asphalt Shingle
	Tar & Gravel
	Membrane - Elastomere
	Metal Tile
	Metal Panel
	Cedar Shake
	Slate
	Other
Additional Questions
	How many years old is your existing roof? 1 year 2 years 3 years 4 years 5 years 6 years 7 years 8 years 9 years 10 years 11 years 12 years 13 years 14 years 15 years 16 - 20 years 21 - 30 years 31 - 40 years 41 - 50 years 51 - 60 years 61 - 70 years 71 - 80 years 80 years +
	What is the slope of your roof? Flat Low Slope Medium Slope High Slope 1/12 2/12 3/12 4/12 5/12 6/12 7/12 8/12 9/12 10/12 11/12 12/12
	Is your roof leaking? Yes No
Name
Address 1
Address 2
City / Town
Province / State
Postal Code / Zip
Telephone
Email