Media Wall Submission Form

1

Name* This field is required.

First Name

Last Name

2

Phone Number* This field is required.

Please enter a valid phone number.

3

Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

4

Appointment* This field is required.Please select a date for your free consultation below:

5

Email* This field is required.

example@example.com

6

Current Condition Photos* This field is required.Please submit 3 clear photos(center, left and right shots) of the wall in which you would like a custom media wall built.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

7

Inspiration Photos* This field is required.Please submit a clear reference photo of a media wall to your personal liking or preference.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

8

Please select the type of service you need.* This field is required.Please select an option below:

9

Select any add-ons you would like on your media wall buildout.* This field is required.Please select all that apply below:

Custom Built Mantel

Flush Mount Tv Recess panel

Floating shelves

Encased Shelving

Niche/Nook

None of the above

10

How many devices do you have that will connect to your TV setup?Please list all device names below:

11

If your wifi boxes will be located in this area, would you like a recessed media box installed behind the TV to hide your wifi accessories ?* This field is required.Please select all that apply below:

Yes

No

I'm not sure

12

Would you like any of the following recessed lighting styles listed below built into your custom floating shelves?Please choose a selection below:

3"-6" Round Recessed lights (Black or White Trim)

Low Voltage Recessed Strip Lights (Cool Tone, Warm Tone, or RGB options)

None of the above

13

For your encased shelves, would you like any of the following recessed lighting styles listed below?Please choose a selection below:

3"-6" Round Recessed lights (Black or White Trim)

Low Voltage Recessed Strip Lights (Cool Tone, Warm Tone, or RGB options)

None of the above

14

What is the total ceiling feet height in the room for the requested media wall?* This field is required.Please select an option below:

8’-10’

10’-12’

12’-20’

20’ or more

15

What is the total width in feet of the existing wall in which you’re requesting a media wall built?* This field is required.Please select an option below:

8’-10’

10’-12’

12’-18’

18’- or more

16

What size in width(ft) would you like the custom media wall built?* This field is required.Please select an option below:

6’-8’

8’-10’

10’-12’

Not sure yet

17

What size TV do you have?* This field is required.Please select an option below:

50’ or less

55’-60’

65’-70’

70’ or greater

18

In total width, what size electric fireplace do you prefer ?* This field is required.Please select an option below:

50’ or less

55’-60’

65’-70’

70’ or greater

Not sure yet

19

Do you want baseboard trim installed on the custom media wall?* This field is required.Please select an option below:

YESNO

20

Do you currently have crown molding trim installed in the room you’re requesting a media wall?* This field is required.Please select an option below:

YESNO

21

What is your total project budget?* This field is required.Please select an option below:

$3,000-$3,800

$3,800-$4,600

$4,600 or more

22

Discount CodeEnter your discount code below:

23

Discount ConfirmationCongratulations!

Click Next

24

When are you looking to schedule a guaranteed start date to build your custom media wall?* This field is required.Please select an option below:

As soon as possible

Next month

A few months from today

25

How did you hear about us?* This field is required.Please select an option below:

Referral or reference

Facebook or Instagram Ad

TikTok

Yard sign

26

Did we missed anything?Please tell us if there’s anything we might have missed or need to know about your requested media wall down below: