 | ARCHITECT ORDER FORM
Note: This program provides a 40% DISCOUNT up to $1500.00 for VELUX products when installed in the personal residence or place of business of a licensed architect, certified residential designer or certified interior designer. The maximum discount is applied only on orders of $3,750 or more.
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| *Name: |
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| Firm Name: |
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| *Address: |
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| *City:
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| *State: |
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| *Zip: |
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| *The installation address is... |
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| *Phone Number: |
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| *Fax Number: |
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| *Email: |
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| *Address of VELUX Installation: |
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| *City: |
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| *State: |
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| *Zip: |
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| Personal
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| (A VELUX representative may contact you to confirm your status as a licensed architect, certified residential designer or certified interior designer.) |
|  Are you a member of the AIA or AIBD?
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| If so, please indicate AIA/AIBD membership number:
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|  If you are not an AIA or AIBD member but are a licensed architect, please enter license number:
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| Business
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|  What is the % breakdown of residential and commercial business at your firm? |
| Residential
Commercial
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|  If you design primarily commercial structures, in which two (2) segments do you focus most? |
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Institutional
Urban Mid-Rise
Sloped Roof Commercial
Other |
|  What is your firm's approx. number of projects annually?
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| How many of these include skylights?
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|  Do you specify skylights by brand name?
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| If so, which brand do you prefer? Residential:
Commercial:
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|  If you specify commerical skylights, do you prefer acrylic or polycarbonate?
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|  How often do you believe you will incorporate skylights in the next five years?
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|  Select the top two aspects that will impact your decision to use skylights in future projects: |
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2.
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| VELUX America Inc. is an AIA and AIBD CES Provider.
Would you be interested in a continuing education program from VELUX?
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Instructions for Ordering:
Begin your selection by clicking in the first cell on line #1. Select your product from the list that will appear.
Continue with Line #2, etc. if more product is needed. |
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| Credit card information will be needed when a VELUX rep calls to confirm your order.
Your credit card will be billed for list price less 40%, plus a S&H charge and sales tax as applicable.
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