GLOBAL LIFT CORP ORDER FORM Proformance Series Office Email: [email protected] Sales Leads: [email protected] Distributor Dealers Name: Name:

Phone #: Phone #:

EMAIL: EMAIL:

Shipping UPS is our standard Other shipping instructions: Information: Customer Name: Shipping Installation Address: Address:

Phone #: Phone #:

Contact Name: Contact Name: Proformance Series Lift Options Model : P-375 Seat Direction: While sitting in the lift chair, the pool or spa must be Right Seat Only On your right for use. Is the Proformance Series Lift being used for a Pool or Spa? Application: Pool Spa Location: Indoor Outdoor

Concrete Anchoring System with No Anchoring System Anchor Sleeve Proformance Series Lift Accessories Protective Cover (Blue) No Cover Protective Cover (Tan) Additional Battery Signature & Ordered By: Date: Please order 1 Lift per Order Form

QUO-712; Rev 2; 07/19/2011 Specializing in Commercial Grade Pool Lifts - 866-712-0606