QUOTE REQUEST FORM

SOUTHLAND APPLIANCE CORP.
3905 Indian River Rd. Cheasapeake VA 23325
(757)420-1020

Where Service Still Matters !


email :
home phone: work phone: cell phone:
how would you prefer we contact you:
first name: last name :
address : city : state : zip :


Models/description













Would you like: delivery install(built-in) drop off pick up

additional comments: