Application

PayPal/Credit Card

If you'd like to pay online using PayPal, complete and submit the form below.

Check

If you'd like to pay via check, download the PDF version of this form by clicking here to complete by hand.

Please print application and send to:
Designed Sealed and Delivered
7650 Dutch Rd
Saginaw, MI 48609
When we receive your application, we will email you a confirmation along
with an invoice. Your order will be processed upon receipt of check.
Thank you!

Personal Information:
N ame
E-mail
Phone
Job site
Country

Design packge desired

What is your design style?

Elaborate if necessary

ROOM(S) TO BE DESIGNED
Room	Dimensions	Budget (if purchasing mini or big box)

Label

Number of people that live in your home:

Number of children living in your home:

Ages of children:

Occupations of household members:

Do you work from home?

If yes, is there any space required in this room for work?

Which direction does the room face (N,S,E,W)?

What is your entertaining frequency (if applicable)?

What do you consider your design style to be?

Other special requirements or information you would like us to know about your home or lifestyle:

Return to home page