Pools Patios and Porches 301-698-1200 2 Wormans Mill Ct., Frederick, MD 21701 21018 Jefferson Blvd., Smithsburg, MD 21783 Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Contact Phone*Your Pool InfoPool Type*Select OneIn GroundAbove GroundPool Size* (width x length x depth)Do you have an attached spa?*Select OneYes (add $99)NoDo you have a negative edge?*Select OneYes (add $150)NoPool Surface*Select OneVinylPlasterConcreteFiberglassType of Sanitizer*Select OneChlorineSustainSaltFROGNature2BaquacilType of Winter Cover*Select OneSafety - SolidSafety - MeshSafety - Solid with water bags or Winch/CableNo coverType of Filter*Select OneSandCartridgeD.E.DesjoyauxPool Chemical OrderSAVE 20% on chemicals until May 31st. Selected chemicals will be delivered with your pool opening. Since you are asking for our assistance to open your pool, we will only use chemicals that we provide or are purchased from PPP. We will not use chemicals purchased elsewhere.Chlorine Options: 3 Inch Tabs Shock Algaecide Chlorine 3 Inch TabsSelect One50 lbs.25 lbs.10 lbs.Chlorine ShockSelect OneTurbo Shock - Box of 12 1lb BagsTurbo Shock - Box of 24 1lb BagsTurbo Shock Bucket - 17lbsTurbo Shock Bucket - 25lbsChlorine AlgacideSelect OneAlgaebomb 60Defend+Algaecide 90Sustain Options: Summer Shield 3 Inch Tabs Energizer Sustain ShieldSelect OneQuartHalf GallonSustain 3 Inch TabsSelect One25 lbs.16 lbs.6.6 lbs.Sustain EnergizerSelect One35 lbs.20 lbs.10 lbs.Salt Options: Salt Algaecide SaltSelect One40 lbs.AlgaecideSelect OnePoly 60Defend+FROG Options: Mineral Reservoir Bac Pacs Algaecide Shock Mineral ReservoirSelect OneIn GroundAbove GroundBac PacsSelect OneStandard 2.2 lbs.XL Pro 7 pbs.AlgaecideSelect OneFROG BAM (90 Day)Poly 60ShockSelect One1 lb.Bucket (24 Bags)LiquidNature2 Options: Mineral Cartridge 3 Inch Tabs CL Sticks CL Shock Algaecide Mineral Cartidge OptionsSelect One35 Gallons45 Gallons3 Inch CL Tab OptionsSelect One50 lbs.25 lbs.16 lbs.CL Stick OptionsSelect One25 lbs.8 lbs.Algaecide OptionsSelect OnePoly 60Defend+CL Shock OptionsSelect OneMulti Magic (Suggested)Zap ItLiquidBaquacil Options: Sanitizer Oxidizer CDX Algaecide AD System Algaecide OptionsSelect OneStandardCDXAD System OptionsSelect OneSanitizerOxidizerAlgaecide 10Algaecide 20Pool Opening ServicesSchedule Your Opening BEFORE May 20 and SAVE 20% on Pool Chemicals – Frog, Poolife, Sustain, Baquacil Chemicals delivered with opening. Openings scheduled after May 20 will be charged full price.Pool Opening Type:*Select OneDeluxe - $725 (after May 20 - $850)Standard - $560 (after May 20 - $650)Basic - $435 (after May 20 - $525)All openings include balancing chemicalsWhen would you like to open your pool?*March 13-31April 3-14May 15-26May 30-June 9June 12-16Additions to My Opening YES, I approve repairs up to $300 to be scheduled as soon as possible. YES, I want you to start my season with NEW pleated filter cartridges and SAVE 20%! YES, I want a FREE Quote: New Pool Liner New Winter Safety Cover New Heater New Pump Pool Maintenance ProgramSchedule our service team to maintain your pool. MONTHLY: 4 visits per month, includes balancing chemicals Monthly Maintenance Program: YES - $570 per month NO Additional CommentsPaymentA 50% deposit is required with reservation via credit card, check or cash. A valid credit card (MC/Visa/Discover/AmEx) and a signed authorization to charge your credit card for work and chemicals must be on file for all customers. Your credit card will be charged within 48 hours of completion of work unless you elect to pay by check or cash at one of our locations prior to your card being processed. Today's Date* MM slash DD slash YYYY Submittal of this form is considered an electronic signature. Once form is submitted, we will call you to verify all information and obtain credit card information for the deposit.