A.J. Rose Carpets & Flooring

CALL US AT
781-272-7600
(Burlngton)
or
508-652-0770
(Natick)

Ask about our nationally-certified Karastan installers!

"Hey, I'm a flooring man, not a singer"

FREE STAIN REPELLENT UPGRADE !!

Please complete this brief survey and we will give you a coupon for a free stain repellent upgrade (one room only) on your next carpet or upholstery cleaning

1. How did you hear about us?
Web search Referral Magazine Previous Customer TV Radio
Other:

2. Have you seen us advertised on

	Yes	No
TV ?
Radio ?
Newspapers ?			Which newspaper?
Magazines ?			Which magazine?
Direct Mail?

3. What is your purchase time frame?
Immediate less than 3 months 3-6 months over 6 months

4. Contact Information
Please note: It is the policy of A.J. Rose Carpets & Flooring never to share and distribute information entered into this request form. If you so choose a salesperson will contact you to discuss your flooring needs.

Please have a salesperson contact me

Name:
Phone:
Email: