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NJS Electrical Services
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Intake form
Help us serve you better
Name
*
Email address
*
Phone number
Type of electrical service needed
Please select at least one option.
Residential wiring
Commercial wiring
Electrical repairs
Lighting installation
Electrical maintenance
Panel upgrades
Generator installation
Preferred appointment date
Preferred appointment time
Budget range
Select
Under $100
$100 - $500
$500 - $1000
Over $1000
How did you hear about us?
Select
Google search
Social media
Word of mouth
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Additional questions or comments
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