Credit Display Flooring Request Form

Date *

Email *

Location *

USA
Canada

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Canada Address *

Distributor Phone *

Sales Rep *

Type *

Dealer Display Floor
Model Home

Please Note: Wall Tile Authorized For Builder Model Homes Only

Dealer Display Floor Information

Model Home Builder Display Floor & Wall Information

Original PO# Number

Dealer Name *

Dealer Phone Number *

Dealer Address *

Address Line 1

Address Line 2

City

State

Zip Code

Dealer Canada Address *

Number Of Products *

1
2
3
4

Product Series 1 *

Product Color 1 *

Product Size 1 *

Product Sq Ft 1 *

Product Series 2 *

Product Color 2 *

Product Size 2 *

Product Sq Ft 2 *

Product Series 3 *

Product Color 3 *

Product Size 3 *

Product Sq Ft 3 *

Product Series 4 *

Product Color 4 *

Product Size 4 *

Product Sq Ft 4 *

Builder Name *

First

Last

Builder Phone Number *

Track or Development Name *

# Of Homes *

# of Models *

Value of Homes *

ie - 100k - 500k

Builder Location *

USA
Canada

Builder Address *

Address Line 1

Address Line 2

City

State

Zip Code

Builder Canada Address *

Area Installed *

Number Of Products *

One
Two
Three

Series 1 *

Color 1 *

Size 1 *

Sq Ft 1 *

Series 2 *

Color 2 *

Size 2 *

Sq Ft 2 *

Series 3 *

Color 3 *

Size 3 *

Sq Ft 3 *

Additional Notes

Additional Notes, Products or Requirements

Total square footage used in Model Home Floor / Wall (Maximum Participation is 300 SF Floor; 150 SF Wall**)

Total square footage used in Dealer Display Floor / Wall (Maximum Participation is 300 SF Floor; 150 SF Wall**)

Total Pieces of Decos used in Model Home Floor / Wall (Pieces less than or equal to 10% of Floor / Wall SF)

Total Pieces of Decos used in Dealer Display Floor / Wall (Pieces less than or equal to 10% of Floor / Wall SF)

Total $ Amount

Total Project Value

Total Amount of Credit Requested (Include All Required Forms & Approvals)

Total Pieces of Decos used in Model Home Floor / Wall (Pieces less than or equal to 10% of Floor / Wall SF)

General Manager

First

Last

Regional Sales Manager

First

Last

Date / Time

Image Upload *

Click or drag files to this area to upload. You can upload up to 5 files.

Please upload and compress 3 to 5 images or convert to png if needed (max total file upload size 30mb)