FINANCING

Please fill in the form and someone from Mandarin Carpets will contact you regarding the completion of your financing application.

Full Name:
Email Address:
Home Phone:	(xxx)-xxx-xxxx
Alternate/Cell Phone:	(xxx)-xxx-xxxx
Mailing Address:	(no PO Box)
Address Line 2:
City:
State:
Zip:
Time at Address:	Years:  Months:
Housing Information:	Parents/Relative Own Rent Other