Refurbishment Form

* First Name:

* Last Name:

* Address Line 1:

* Address Line 2:

* Country:

* State:

* City:

* ZIP Code:

* Phone:

* Email:

* Confirm Email:

What is the name of your chime? The name can usually be found on the windcatcher hanging at the bottom. If you don't know the name and can't find it, please type unknown into the entry field.

* Chime Name:

We require a picture of your chime. This serves as proof of ownership and assists us in identifying the chime. Please be sure all parts of the chime are visible in the picture, including the top, the windcatcher, and tubes. (We understand some pieces may be missing!)

* Chime Image:

* What kind of product would you like to refurbish?

* Number of tubes:

* Length of the longest tube:

* Length of the shortest tube:

* Tube Color:

* Tube Shape:

* What material is the chime top?

* What is the diameter/width of the top (in inches)?

* What is the shape of the top?

* Are your tubes angled at the bottom?

* Is your chime's windcatcher personalized?

* Is your chime less than a year old?

* Are there any other distinguishing features about your chime?

Information About You

Information About Your Woodstock Chime

Additional Information