American Carpet Wholesalers - Buy Wholesale Direct on Name Brand Carpet, Hardwood and Laminate Floors
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   Sample Request            


   In order to better serve you, please complete our form.

  1. Please tell us where to send your sample. The address must be UPS deliverable. UPS does not deliver to PO Boxes.

    Name
    Street Address
    Address (cont.)
    City
    State/Province
    Zip/Postal Code
    Country
    Home Phone
    E-mail
  2. Select any of the following options that apply:

    Carpet          Area Rug        Hardwood        Laminate      
    Vinyl Flooring  Other           
  3. If you are ordering samples other than products posted on our website, please fill out the form completely. For samples of products on our website, style and color is all that is necessary. Please list approximate quantity you plan to purchase of each product.

    Product # 1

    Manufacturer
    Style
    Style Number
    Color
    Color Number
    Quantity
    Is Your Quantity Sq Yds or Sq Ft?
  4. Please provide the following product information:

    Product # 2

    Manufacturer
    Style
    Style Number
    Color
    Color Number
    Quantity
    Is Your Quantity Sq Yds or Sq Ft?
  5. Please provide the following product information:

    Product # 3

    Style               
    Color
    Quantity
    Is Your Quantity Sq Yds or Sq Ft?
  6. Please provide the following product information:

    Product # 4

    Style
    Color
    Quantity
    Is Your Quantity Sq Yds or Sq Ft?
       
  7. When do you plan on purchasing floor covering?

    0-1 Month
    2-6 Months
    7-12 Months
    Unsure


 

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