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Name	Quantity
T4 or T6 Non-Programmable Thermostat

Registration

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Address information

First name*

Last name*

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Number of Floors

Square Footage of Home

Existing Furnace Model#

Existing A/C Unit?

yes no

Existing A/C Unit Make & Model#

Use Existing Thermostat if Possilbe?

yes no

Model# Brand of Preferred Thermostat

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