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*Fill Out The Form Below To Help Us Better Serve You*
First Name:
Last Name:
Phone:
Email Address:
Address:
City:
State
Zip Code:
WHEN DO YOU PLAN ON MAKING YOUR PURCHASE? :
-Select One-
One To Three Months
Three To Six Months
Over Six Months
WHAT TYPE OF FLOORING ARE YOU INTERESTED IN?
Carpet
Hardwood
Tile
Vinyl
Laminate
Water Proof Floors
ARE YOU A RETURNING CUSTOMER?
Yes
No
HAVE YOU BEEN IN THE STORE IN THE LAST 30 DAYS?
Yes
No
DO YOU HAVE ANY ORDER PENDING WITH THE STORE?
Yes
No
WHAT TYPE OF MEETING WOULD YOU LIKE?
-Select One-
Phone
Online - (Via Zoom or Skype)
HOW DO PREFER TO BE INITIALLY CONTACTED? :
Send Email
Phone Call
No Preference
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