Gallo Design, Inc.

Name*:
Address:
Phone:
Fax:
	In-home measure: $35.00 within 10 mile radius, $0.45/mile thereafter
	Installation: $6.00 per foot width ($50.00 minimum) within 10 mile radius, $0.45/mile thereafter
	Fabric Swatch: Check this box and fill out the portion below with the names of the fabric swatches you would like to receive. $5.00 per swatch. Money will be credited back to you if an order is placed.
* We will contact you for an appointment and directions. *Payment due at time of service.

via email or print and fax to: 410-208-6968