Please complete the following form
to efficiently process your request for measure.

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General Information
Date:
Your Name:
Phone Number:
Billing Information
Purchasing Agency Name:
Contact:
Address Line 1
Address Line 2
City:
County:
Zip Code:
Fax Number:
Purchase Order Number:
For Measurement Contact:
Phone Number of Contact:
Fax Number of Contact:
Number of Buildings:
Number of Windows to be Measured:
Type of Blinds:	1" Decor Miniblinds 2" Aluminum Miniblinds
Color:	110-Gloss White 125-Bright White 127-Linen Flirt 173-Eggshell 18-Satin Silver 180-Dove Gray 186-Beige 190-Bright Aluminum 2 - Alabaster 205-Fawn 267-White BLush 268-Creme D'L Creme 269-Chenille 270-Linen 275-Blossom Mist 276-Silverado 318-Silver Cloud 350-Vanilla 405-Gray Flannel 413-Hunter Green 48-Black 64-Bronze 748-Shadow Gray 795-Surf 820-Umber 830-Almond 837-Rosewood 840-Azure 885-Flex White 973-Antique White 974-Pearl 981-Platinum Gray 983-Graphite 1 - Glacier White 65-Brushed Aluminum
Address of Location to be Measured:
Company Name:
Address Line 1:
Address Line 2:
City:	State:	Zip:
Phone:
E-mail: