Full Name
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Email
*
Home Phone
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Mobile Phone
*
Customer Status
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New Customer
Existing Customer
How did you hear about American Rug Laundry (ARL)?
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Newspaper
Radio
Search Engine (Google, Yahoo etc.)
Social Media
Referral
Postcard
Email Message
Text Message
Has your rug ever been cleaned professionally?
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Yes
No
I don’t know
Indicate which services you are interested in (check all that apply)
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Area rug cleaning
Pet urine & odor removal
Rug repair or restoration
De-mothing or moth-proofing
In home carpet, hard surface or upholstery cleaning
Rug pad, carpet protection or storage wrap
Will need Pick-up & Delivery Service
Will be dropping rugs off
Please provide as much information as possible regarding your cleaning needs. List the size of rugs, make of rugs (handmade or machine-made) and any pre-existing issues of rugs.
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Upload Images for Rug Identification (include front and back of rugs)
* Please upload images totaling a max. of 40MB - gif, png, jpg/jpeg
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