Use this form to order samples of any Lees Carpet or call 1-800-523-5647 to talk to customer Service


 *  All information Required

Style Number
Color Number
Sample Size
1
2
3
4
5
6

 

 

 

 

 

Note:For the following styles listed, only 24" tile samples are available.
Styles: Click Here to View Styles.

CONTACT INFORMATION
Name of person ordering:
Email Address:
Contact Phone Number:
Account Number:
Company:
Need by Date:
Project Name/Side Mark:

 

 

 

 

 

SHIPPING INFORMATION: 
Name:  
Address1:
Address2: 
City:
State/Prov: 
Zip/Postal:
Attn: Phone Number:
COMMENTS

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