Contact at Firm *

First Name

Last Name

Business Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Business Description

(please select all that apply)

Residential Interior Designer

Residential Architect

Commercial Interior Designer

Commercial Architect

Retailer

General Contractor

Business is Tax Exempt *

If so, please submit your EIN/ resale certificate to hello@laine-and-alliage.com

Yes

No