HPG SMS Campaign

Fields with * are mandatory.
1. Name of the Customer:  
2. Address of the Customer:  
3. Nearest Landmark Your Home:  
* 4. Mobile Number:  
5. Landline Number:  
6. Customer’s E-mail ID:  
* 7. Courier Address (To Receive Courier):  
* 8. Source of Information on HPG:
TV Press Website Facebook Painter Dealer Friends & Relatives
 
* 9. When are you planning to paint the house?: Within a month After a month
10. Planning to paint: Interior Exterior Both
11. Comments if any:
* Verification: