Flooring Qualification Questionnaire

Your name:
Your E-mail Address:
Company Name:
Phone Number:
Address:
City:
State/Province:
Zip/Postal Code:
Country
1. What does your company do? 


2. What do you do for your company?  


3. Is this ESD Floor for an existing building or a new building?  


4. Do you own or rent the building?  


5. Where will the ESD Floor be used?  





6. What is the square footage of the floor?  


7. What type of ESD Floor are you intrested in?  


8. Which ESD Product(s) are you interested in learning more about?  





9. When do you plan to begin this project?  



10. Who will install the floor?  


11. What is the surface to be covered?  



12. What is the condition of the surface to be covered?  


13. What is the elevation of the floor?  


14. Has the floor been moisture tested?  




15. Are you looking to meet an Electrical Specification?  



16. Who will test the electrical reading on the floor?  


17. Ergonomic Preferences-Please check all that apply:  



18. Aesthetic Preferences-Please check all that apply:  




19. Maintenance Requirement-Please check all that apply:  



20. How important is cost consideration?  






21. Is there anything else we should know?

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