First Name		Last Name
Company
Address
City		State
Zip		Phone  -  -
Fax		-  - E-mail

Have you worked with a designer before?	Yes	No
What type of project?	Residential	Commerical
What does your project entail?	Building	Renovation
	Decoration	Design
	All of the Above	Other
What is the square footage?	Sq.Ft.
How many rooms?	Rooms
What is the style for the project	Traditional	Contemporary
	Period	Eclectic
	Other
Are you the sole decision maker?	Yes	No
If No, please specify i.e. Spouse, Business Manager, etc.
What is your budget?	30-$50,000	50-$100,000
	100-$200,000	Over $200,000
What is the start date for the project?
What is the expected completion time for the project?	3 months 1 year	6 months other

Pacific Design Center
c/o Pacific Design Services LLC
8687 Melrose Avenue, Suite M-60
West Hollywood, California 90069-5701