Custom Floor Mat Template Form

Please print and read read this form carefully, and complete all the required fields. Once you have completed this form, please mail this along with your custom temples to:

Quality Car Mats
655H Fairview Rd #320
Simpsonville, SC 29680

Contact Information
Name ______________________________________________
Address ______________________________________________
Address Line 2 ______________________________________________
City, State, Zip ______________________________________________
Phone ______________________________________________
Email ______________________________________________
Best time to call ______________________________________________
 
Floor Mat Details
Vehicle Make ______________________________________________
Vehicle Model ______________________________________________
Vehicle Year ____________
Vehicle Description (ex, 2 Door, 4 WD, Extended Cab, etc)  
Number of Floor Mats ____________
Carpet Material Type (check one) [   ] Plush Tufted Nylon    [   ] Luxury Tufted Nylon  [   ] European Style Berber
Carpet Color ______________________________________________
Binding Type [   ] Nylon [   ] Serging
Binding Color ______________________________________________
Embroidery Options (Only available for front mats, and cargo area. Must be completed for all mats with embroidery.) Please tell us a description of the mat that will be embroidered (Example: Front Driver, or Rear Cargo)
Mat Description ______________________ Mat Description ______________________
Font Type [   ]Block [   ]Script Font Type [   ]Block [   ]Script
Capitalization [   ]As Typed [   ] All Caps Capitalization [   ]As Typed [   ] All Caps
Orientation [   ]Horizontal [   ]Vertical Orientation [   ]Horizontal [   ]Vertical
Thread Color _______________________ Thread Color _______________________
Text _______________________ Text _______________________
Heel Pad (Only available for the driver side floor mat) [   ] Yes [   ] No
 
Payment Information - If you include your credit card information for payment, we will still contact you with a price prior to charging your card.
Name on card ______________________________________________
Card Type [   ] MasterCard [   ] Visa [   ] Discover [   ] American Express
Card Number ______________________________________________
Card Expiration Date ______________________________________________
Card Security Code _________
(For Visa, MC and Discover, this will be the last 3 digits on the back of your card. For Amex, this is the 4 digit number on the right of your card, just above the account number)