Vendor Application

General Information

First Name

Middle Name

Last Name

Company Name (if applicable)

Email

Address

City

State

Zip Code

Cell Phone

Office Phone

Fax

Location

Please select the United Installs locations for which you would be willing to work (may check multiple):
Cincinnati, OHDayton, OHColumbus, OHErlanger, KYLexington, KYLouisville, KYFrankfort, KYGeorgetown, KYMoorehead, KYAugusta, GAPiedmont, SCGreenville, SCAiken, SCNorth Augusta, SCNewberry, SCSouth West Augusta, GA

Trade Skills

Select surfaces for which you are qualified to install (may check multiple):

Please list any flooring training, certifications, or experience below (including years of experience):

Additional Information

Please select if you would like to work on residential jobs, commercial jobs, or both:
CommercialResidential

Are you willing to submit to a background check?

Additional Notes