Floor To Ceiling - "Design Life. Begin Here."

Thank you for your interest in Floor To Ceiling®'s membership program. While we are pleased to provide this method of requesting information, it is important to note that submitting this request does not constitute a membership application.

To help us provide you with the most meaningful information about our membership programs, please complete as much information as possible in the form below. A minimum of the required fields (indicated with a red asterisk) must be provided to submit the form. All information submitted will be kept strictly confidential, and we do not share or sell any information received. We'll contact you promptly upon receipt of your request.

NEW! Take a virtual tour of the entire
Floor To Ceiling® membership program! Simply check the box in the form below and we'll mail you a FREE, fully interactive computer CD which includes a store tour and detailed information about all our membership programs.

(*Required fields)

Please provide your contact information:

*Name:

*Address:

Suite / PO Box:

*City:

*State:

*Zip Code:

*Daytime Phone:

*E-mail:

If applicable, please tell us about your existing store:

Store Name:

Store Address:

City:

State:

Zip Code:

Store Phone:

No. of Stores:

	1
	2
	3
	4 or more
	N/A

Please indicate how you'd prefer to be contacted:

*Select One:

	Telephone
	Mail
	E-Mail

NEW: Take a virtual tour of success!

Would you like to receive a free interactive CD containing the details of our membership programs?

YES

No special software or downloads are required to use this CD. (Requires Windows 95 or later.)

Please indicate your area of interest:

*Select One:

	Membership program in general
	Opportunities for my existing business
	Opportunities for a new-start business

Please check all product lines that apply
to your existing or new-store interest:

Kitchen & Bath:

	Cabinets
	Fixtures
	Counters
	Appliances
	Whirlpools

Flooring:

	Carpet
	Vinyl
	Ceramic
	Hardwood
	Laminate
	Area Rugs

Decorative Products:

	Wallpaper
	Blinds
	Draperies
	Paint
	Lighting
	Accessories

Please enter any questions or comments here:

All information submitted to
Floor To Ceiling®
will be held in strict confidence.

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Thank you for your interest in Floor To Ceiling!

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