Please Fill Out the Registration Form Below Personal Information Product Information Store Information Personal Details Tell us something about you First Name Last Name Email Phone Street Apt, suite, etc (optional) City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota N Marianas Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming --- Canada Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador North West Territory NW Territories and Nunavut Nova Scotia Nunavut Ontario Prince Edward Island Quebec (PQ) Quebec (QC) Saskatchewan Yukon State Zip - indicates required field Please correct the invalid fields. Product Information Tell us about the product. If you have more than one product to register, you will have the option to register another product after clicking the "Submit" button on step 3. Purchase Date Installation Date Carpet Hardwood Laminate Vinyl Tile & Stone Floorigami/Soft Modular Floor Type Sq. Yards Sq. Feet Rug Floor Unit $ Price Per Unit Number Of Units Purchased Floor Style Name Floor Style Number Floor Color Name Floor Color Number Select any additional items you may have purchased with your flooring. Trim pieces Transition pieces Sundry pieces Accessory pieces - indicates required field Please correct the invalid fields. If you need help completing this form, please contact us. Store Information Tell us about where you purchased your product Dealer Location (City) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota N Marianas Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming --- Canada Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador North West Territory NW Territories and Nunavut Nova Scotia Nunavut Ontario Prince Edward Island Quebec (PQ) Quebec (QC) Saskatchewan Yukon Dealer Location (State) Dealer/Store Name Dealer/Store Name Invoice Number Upload Your Invoice Did you work with a Shaw Consumer Concierge? Yes No Did you utilize the "See in YOUR room" feature to help you with your decision to choose Shaw Floors? Yes No I�d like to receive courtesy reminders for care and maintenance on my new Shaw Floor* *By submitting the form, you agree to Shaw Floors Terms and Conditions. - indicates required field There was an error loading the retailers within 50 miles of the specified city/state. Please try again. Invalid invoice type. The Invoice file is too large. Maximum size is 20MB. There was an error uploading the invoice file. Please correct the invalid fields. We cannot process your request at this time. Please try again. We�ve detected a duplicate order. Invoice Numbers must be unique. If you ordered the same product twice that day, please enter an appropriate invoice number for the 2nd order. If you need help completing this form, please contact us. Register Another Product Do you have another product to register?
Please Fill Out the Registration Form Below Personal Information Product Information Store Information Personal Details Tell us something about you First Name Last Name Email Phone Street Apt, suite, etc (optional) City Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota N Marianas Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming --- Canada Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador North West Territory NW Territories and Nunavut Nova Scotia Nunavut Ontario Prince Edward Island Quebec (PQ) Quebec (QC) Saskatchewan Yukon State Zip - indicates required field Please correct the invalid fields. Product Information Tell us about the product. If you have more than one product to register, you will have the option to register another product after clicking the "Submit" button on step 3. Purchase Date Installation Date Carpet Hardwood Laminate Vinyl Tile & Stone Floorigami/Soft Modular Floor Type Sq. Yards Sq. Feet Rug Floor Unit $ Price Per Unit Number Of Units Purchased Floor Style Name Floor Style Number Floor Color Name Floor Color Number Select any additional items you may have purchased with your flooring. Trim pieces Transition pieces Sundry pieces Accessory pieces - indicates required field Please correct the invalid fields. If you need help completing this form, please contact us. Store Information Tell us about where you purchased your product Dealer Location (City) Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota N Marianas Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming --- Canada Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador North West Territory NW Territories and Nunavut Nova Scotia Nunavut Ontario Prince Edward Island Quebec (PQ) Quebec (QC) Saskatchewan Yukon Dealer Location (State) Dealer/Store Name Dealer/Store Name Invoice Number Upload Your Invoice Did you work with a Shaw Consumer Concierge? Yes No Did you utilize the "See in YOUR room" feature to help you with your decision to choose Shaw Floors? Yes No I�d like to receive courtesy reminders for care and maintenance on my new Shaw Floor* *By submitting the form, you agree to Shaw Floors Terms and Conditions. - indicates required field There was an error loading the retailers within 50 miles of the specified city/state. Please try again. Invalid invoice type. The Invoice file is too large. Maximum size is 20MB. There was an error uploading the invoice file. Please correct the invalid fields. We cannot process your request at this time. Please try again. We�ve detected a duplicate order. Invoice Numbers must be unique. If you ordered the same product twice that day, please enter an appropriate invoice number for the 2nd order. If you need help completing this form, please contact us. Register Another Product Do you have another product to register?