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Name
Company
Address
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E-mail Address   (*Required)
Phone

Architect or Designer's Name   (*Required)
Architect City   (*Required)
Project Name / City / or Sidemark   (*Required)
I am a First-Time Visitor and would like complete information.

Sample Size:   (Please Check One)

(Custom size samples available for design boards, etc.)

 5x8       8x10      18x20
Quantity Sample ID# / Description / Company / or Folder Description
Shipping Requirements:
We take pride in fulfilling your sample needs and making sure they arrive on time. Please indicate below when these samples need to be on your desk, and our staff will guarantee their arrival!
Day (M-F) * Month * Date (1-31) * Select One: *
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* The above information is required to assure your sample request arrives on time.
Thank you!
     

*NOTE: E-mail Address, Architect or Designer's Name/City/and Project Name, Shipping Date

are REQUIRED for submission.  THANK YOU!

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1005 S. 60TH STREET | Milwaukee, WI 53214 | 414.771.9166 | TOLL FREE 800.522.9166 | www.FloorsByShannonSales.com