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Carpet Swatch Order Form
 
CARPET SAMPLE INFO
Carpet Manufacturer:
Style Name:
Style Number:
Color Name:
Color Number:
Swatch Size Desired:
Required Sample Delivery Date:
 

 

SAMPLE SHIPPING INFO
* Customer Name:
Street Address:
City:
State:
Zip Code:
Phone#:
Fax#:
* E-mail:
 

 

PROJECT INFO
Project Name:
Approximate Sq. Yds. Required:
Carpet Budget (material cost) Per Sq. Yd.:
Custom Color Match Required: YES NO
Date Required for Carpet Installation:
Special Comments or Questions:
* required fields- need to be filled out before you submit