Room in a Box Fill Form
Name:
Last Name:
Adress: City:
Zip Code : State: E-Mail:
Phone:
Fax:
What room do you want us to design?:
What style do you like?:
What colors and patterns do you like?:
What special consideration should we have? (kids, pets, older persons, people with disabilities):
Is there any magazines, blogs or designers that you like?:
What is your budget?:
I understand that the fee of $: for Room in a Box is non refundable.
We accept PayPal
Client Signature:
Date: