Shopping Form

Fill out the following form, indicating your boutique preference if one is local to you, and someone will be in touch with you shortly.  If you have more than one room, feel free to fill out the form as many times as you like.

CONTACT    
Name  
Address  
City, State, Zip   ,
Phone  
Fax  
Email  
How would you prefer we contact you?
Do you have a store preference?
ROOM

Number of windows

   
Window Measurements...
   
 

A to B

C

D to E

F to G

H

1

2

3

4

Colors in the room

Colors that you might like

Our curtains come in many different colors and designs. Please select all those that interest you
(you may select more than one).
Solids Subtle stripes Bold stripes
Bold plaids Overall pattern Printed fabrics
Please select your preferred fabric
(you may select more than one):
Silk taffeta Silk dupion Cotton
Linen Cotton blend Chenille
Silk Sheers

Please select your budget Per Window:

How did you hear about us?
(Press CTRL for multiple selections)

If Other, please specify.


Is there anything else we need to know before contacting you?
   

 
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