Welcome to Floorco - Membership

Membership

Primary Account Holder Information
First Name:
MI:
Last Name:

Street Address:
City:
State:
Zip:

Home Phone:
Mobile Phone:
Work Phone:
Fax:
Email:
* To receive referral payments, we will need to contact you by phone for Social Security and driver's license numbers.

Company Information
Company Name:

Company Address:
City:
State:
Zip:

Company Phone:
Company Fax:

Sales Tax #
Expiration Date:
Business Type:
Method of Payment**:
** To receive credit card payments, we will need to contact you by phone for your credit card information.

Client Profile
Will you be sending clients to the showroom by appointment	Yes No
If yes, what percentage should Floorco use when selling your clients?†	Member Cost 10% Referral
† All members must make appointments for any unaccompanied clients. Floorco reserves the right to sell your clients at 10% referral rates unless otherwise specified in writing by you, the member.

Conditions and Rules of Membership
Have you read and agreed to our conditions and rules of membership?	Yes No

Showroom
11226 W. Lapham St.
West Allis, WI 53214
414-727-6525
Hours: M-F 8am-5pm Sat: 9am-12pm

Warehouse
203 S. Curtis Rd.
West Allis, WI 53214
414-774-2771
Hours: M-F 7am-5:30pm Closed Sat & Sun