ELLE CHERIE DESIGN NEW CUSTOMER INTAKE FORM Step 1 of 3 - Contact Information 33% Contact InformationName* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Getting to Know YouWhich method of contact do you prefer?* Email Phone Call Mobile Text What is your preferred availability for contact and meetings?* Morning Afternoon Evening Anytime during the day please check all that applyHave you previously completed a renovation or new home build? No Yes Have you worked with an interior designer before?* No Yes Do you consider yourself to be a quick decision maker?* No Yes Will you be making decisions with another person throughout the project?* No Yes Tell us About Your Renovation ProjectWhat is your ideal start date?* DD slash MM slash YYYY Please briefly describe your project*Do you have a budget in mind for your project?* No Yes Please tell us your estimated budget.please select an estimated budget option...Less than $5,000Less than $10,000Less than $25,000Less than $50,000Less than $100,000Greater than $100,000Have you hired a construction contractor for your project?* No Yes What is the name of the construction contractor company that you hired? Have you created a list of must haves for your project?please write them here...Please give a brief description of your family (include all members of the household):*Describe your favorite ways to entertain - casual or formal; etc:*Special hobbies/ activities:*What design is your house/ year built?*If you had to describe your style in words would it be any of the following?* Eclectic Chic Clean Contemporary Cool Country Cozy Inviting Minimalist Modern Rustic Traditional Transitional Warm please check all that apply...If none of the words apply, please list your design style in your own words.Have you collected reference images that you can show us to help define the style you are after for your home?* No Yes Please list the rooms you would like to work on (e.g. full home renovation, new build, bathroom, kitchen, basement development, etc.)*What activities will you need to be doing in the room(s)? (i.e. entertaining, reading, crafting, sewing, working, watching TV)*How many people would you like to sit in each room?*Do you have space for an island?* Yes No If so, do you need seating at the island, and for how many?Do you lack storage space?* Yes No If so, what do you need the storage space for?What special considerations do we need to be aware of?*Is there a specific piece that must stay in the room(s)? (Armchair, piano, etc.) Please note the size of the piece and send photo for us to reference.*What is the greatest challenge you feel we will have in designing your home? (Use by young children, animals, odd room size, multiple purpose use, lack of storage/square footage, etc.)*Is there something you have, or have seen, that you want to serve as your design inspiration? If you have a pinterest or houzz board, send us a link to what you like.*Are there any colors you really dislike?* Do you have any dislikes for your home?*What would you like to see more of?*What feeling are you seeking to achieve with your room(s)?*Do you want to accompish this all at once or in phases?* All at once In phases Are there any upcoming events that will affect the timing of this project? (i.e. travel, holidays, weddings, pregnancy, children being out of school or coming home from school)*Do you need project management?* Yes No What days can someone be in to accept deliveries?* Thanks to our combined 12 years of experience in this industry, we work with numerous factories and suppliers getting our clients competitive prices. Should you wish to work together, would you want to order products directly from us?* Yes No What is your ideal investment for this project? What is your maximum investment? (Not defining your investment can make for a great deal of unhappiness as your project progresses. You need to know what to expect budget-wise, we just need to understand if there is room for a little extravagance or if strict discipline is required when it comes to your budget.)*How involved would you like to be in the design and selection process?* What is your typical weekly schedule like?*Do you have any other questions for us at this time?* No Yes What are your questions?