Questionnaire

Condition Questionnaire Form
Items marked * are required fields

Name of Organization: *
Contact Name: *
Email: *
Address: *
City: *
State: *
Zip: *
Daytime Phone: *
Title: *
I would also like a: Printed portfolio
DVD portfolio
Copy of "Preserving God's Light"
YES NO Maybe?
1. Do you have Protective Covering?:
If yes, then:
A. Are any of the existing protective coverings leaking, broken or discolored?:
B. Is existing protective covering vented?:
C. Do frames need repair or painting?:
D. Is there any signs of water on the inside of the still, sash or protective covering?:
2. Is there any loose or missing putty around the exterior frame?:
3. Are there any light leaks around the glass or sash?:
4. Are there any obvious gaps between glass and lead?:
5. Can you see sections of the window that bulge in or out?:
6. Are any of the steel reinforcing bars loose, falling, have broken ties or are detached in any way or missing?:
7. Can you see any broken or cracked glass?:
8. Can you notice any flaking or fading glass painting in your stained glass window?:
9. Is there a dark film developing around the lead?:
10. Do your windows appear dingy and losing their appeal?:
11. Have your windows been noticeably repaired before?: