Registration Form for Listing on interiorredesignexchange.com

 

Complete this form and mail it in along with your check.  If you are paying by credit card you may mail or fax the form to: 760-728-9894. 

Please be sure to sign the form.

 

Name: ____________________________________________________________

Business Name:_____________________________________________________

Mailing Address: ____________________________________________________

Address if you want it listed (optional): ___________________________________

E-mail Address: ____________________________________________________

Website Address: ___________________________________________________

Phone/Fax: ________________________________________________________

 

1) What is the Largest Metropolitan City or Area are you near (within 2 hours)?

___________________________________________________________

2) What geographical areas do you cover?

            ___________________________________________________________

3) What services do you offer to clients?

            ___________________________________________________________

4) Do you belong to any professional design organizations?

            ___________________________________________________________

5) Are you going to send a photo of yourself for the listing?

            Yes                  No

 

Payment by:         check          credit card     (fill out the following questions for CC payment)

Name as it appears on the card: ________________________________________

Card Number: _____________________________________________________

Expiration Date: ____ / ___

Amount of charge:  _$_______

Street number and zip code on card billing statement (ex. 136, 92028) __________

 

Signature:                                                                                                  Date: _______

 

Payment for Listings

 

Payment by credit card, or check, is required for a listing.  Your credit card will be charged for the full amount of the yearly fee.  Once your payment is received you will be added to the web site and that will be the date for your yearly renewal.  You will be reminded by e-mail and post mail prior to the expiration of your listing. Listings are good for one year and there are no refunds. Marie Kinnaman Interior Redesigns, Inc has the sole authority to accept listings for interiorredesignexchange.com.

 

Listing Changes

 

All changes for the listing details must be received in writing via e-mail or post mail.