Please Fill Out the Registration Form Below

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Personal Information

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Product Information

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Store Information

First Name

Last Name

Email Address

Phone Number

Street Address

Apt. Suite, etc. (Optional)

City

State

ZIP

Purchase Date

Installation Date

Floor Type

Floor Size

Units

Price Per Unit (optional)

Number of Units Purchased (optional)

Floor Style Name

Floor Style Number

Floor Color Name

Floor Color Number

Did you purchase any of these additional items with your flooring? (Optional)

Trim Pieces Sundry Pieces Transition Pieces Accessory Pieces

Dealer/Store Name

Dealer City

Dealer State

Invoice Number

Upload your invoice, project photos, or other documents (optional)

Please select a file

Did you work with a Shaw Consumer Concierge?

Yes No

Did you use the “See in Your room” feature to help you with the 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 & Conditions)