Home Industry Partner Application

Full Name *

Company Name

Address *

City *

State *

Zip Code *

Phone *

Email *

Referred By

Would you like a fabric sample deck? *

Yes
No
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Do you have a showroom? *

Yes
No
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If yes, do you want a display?

Yes
No
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Select one of the following:

Option 1- Pass a 7% discount to your client

Option 2- Receive a 7% discount and bill your client directly

Option 3- Get paid 3% commission based off of Gross Product Sale

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