NOTE: Builder Enrollment Form must be completed first before this request will process, unless this is a second request for an existing model. If this is the second request, you must enter the original Confirmation number in order to proceed.
* Indicates Required Fields

*Builder:
*Community Name:
*Product Needed By:
*VELUX Rep:
*Product Ship To:
VELUX Dealer:
Dealer Account #:
*Request Date:
PO #:
Dealer Account & PO Numbers Required if product is shipped to dealer location.
*The following product order is for how many models in this community/subdivision?
Previous Order #:
Previous Order # needed only for additional product for a recent submittal for same builder and same project.


Please complete the required fields above before selecting products below.
Line
PRODUCT
Qty
Size
Glass Type/Cladding
Flashing
Accessory
Qty
1
2
3
Special Instructions
(Include any options not listed above)


Merchandising and Display Request
Model HomesDesign Center




Note: Merchandising materials must ship to a VELUX representative's home or office.

Provide product model, size, flashing and blind information here:

Product order forms are to be completed in full.