E-DESIGN QUESTIONNAIRE Thank you for your interest in E-Design. Please fill out the form below and I'll get back to you as soon as possible.YOUR NAME(Required) First Surname YOUR EMAIL ADDRESS(Required) Email Address Confirm Email Address ADDRESS OF PROJECT Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country 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 HOW MANY ADULTS/CHILDREN?ADULTSCHILDRENAGE OF CHILDREN HOW WOULD YOU LIKE TO DESCRIBE THE STYLE OF THE ROOMS YOU WANT TO UPDATE?(Classic, Contemporary, Heritage, Eclectic, Industrial, Minimalistic, Bohemian…..)WHICH ROOM/S WOULD YOU LIKE TO HAVE E-DESIGNED?WHAT DO YOU APPRECIATE MOST IN THE ROOM TODAY?WHAT ATMOSPHERE DO YOU WANT TO ACHIEVE IN THIS ROOM?(light, airy, atmospheric, cozy, formal, representative, exciting, historical, educational)IS THERE FURNITURE, ART, FIXTURES OR ACCESSORIES THAT YOU WANT TO KEEP IN THE ROOM?IS THERE A COLOR SCHEME THAT IS CONSISTENT THROUGHOUT THE HOUSE TODAY?HOW WOULD YOU DESCRIBE THE TYPE OF COLOR SCHEME YOU MOST APPRECIATE FOR THIS ROOM?(light, dark, colourful, moody, neutral, full of contrast)WHAT IS YOUR APPROXIMATE BUDGET FOR THE PROJECT?PLEASE UPLOAD SOME PICTURES OF HOW IT LOOKS TODAY, IF THERE ARE EXISTING ROOM PLANS WITH MEASUREMENTS AND IF YOU HAVE IDEAS & INSPIRATION PICTURES OF HOW YOU THINK IT SHOULD LOOK.FileMax. file size: 50 MB.FileMax. file size: 50 MB.FileMax. file size: 50 MB.FileMax. file size: 50 MB.DO YOU GIVE ME PERMISSION TO USE YOUR PHOTOGRAPHS OF YOUR ROOM DESIGN ON MY WEBSITE & SOCIAL MEDIA(Required) Yes No WHAT IS YOUR TIME FRAME FOR THE PROJECT?WOULD YOU BE INTERESTED IN INVESTING IN ART or BESPOKE FURNITURE?IS THERE ANY ADDITIONAL INFORMATION THAT YOU WOULD LIKE TO PROVIDE?IF YOU HAVE MOOD BOARDS AT PINTEREST or an similar alternative please enclose the linkTERMS & CONDITIONS(Required) I agree to the terms & conditions listed below.All interior design input provided by House of Bennet Interior Design is intended only to enhance aesthetic appearance and also for improved space utilisation at times. The information provided is not at all intended for or to be used for construction purposes. Completion of the project is reliant in part on the Client's provision of information regarding the client's requirements for the project. House of Bennet Interior Design will not be responsible for the means, methods or procedures of construction, fabrication, delivery & installation, or safety precautions in connection with the e-design project; for the acts or omissions of the contractor or any subcontractor, supplier or other person performing the work on the -design project; or, for any failure of them to meet any schedules or completion dates. The arrangement of repairs, replacement or delivery claims for purchases made in conjunction with recommendations for the e-design project are not the responsibility of House of Bennet Interior Design.
