Company Name
Address:
Contact Name:
Contact Number:
Email Address:
Website Address:
Are you a Retailer? YesNo
What type of work do you do? Interior DesignerUpholsterSoft furnishingOfficeRetail outletsUniversitiesHotelsOther (include below)
How long have you been in Business?:
Please provide two companies that you currently use as references:
Additional information
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