Resilite - Wall Padding Request Form

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Wall Padding Request Form

Please fill out the following information or have the information ready if calling Resilite at 800-THE-MATS. This form may be submitted by selecting the submit button at the bottom of the page or you may print this form out & fax it to Resilite at (570) 473-8988.

If you would like to place an order, please fill the entire form out. Do NOT include any credit card information. Resilite will need to call you in order to process the form and to finalize all details. Please provide a daytime phone number.

PRIVACY - Resilite does not sell or give other companies the information that you fil out below.

Contact Information
Please provide the following information. (*) Required fields

*First Name			*Last Name
Title			Organization

*Street Address
Address (cont.)
*City
*State/Province
*Zip/Postal Code
*Country

*E-mail			Home Phone
Work Phone			FAX

Resilite Dealer Name if known

I would like to be contacted by the following option(s):
For each selection, please include the contact information above.

E-mail
home phone
work phone
fax
mail

Comments or Questions:

Description of Room

What type are your walls where the wall padding will be installed:
This is very important. Based upon the wall type, some wall padding types may not be recommended.
Furring strips may be required for installation.

Concrete Concrete Block Cinder/Cement Block Plywood Drywall Ceramic Tile Metal
Brick Other:

Description of Room:
Select all that apply.

Gymnasium Behind Basketball Standard Wrestling Room Gymnastic Facility Weight Room
Martial Arts Facility Aerobics Pre-school Physical Education Pre-school
Other:

Room Dimensions where Wall Padding will be Installed:
This is also very important. Based upon your room and where you would like wall padding, the length of the wall padding must be determined. Obstacles and pilasters will cause additional needed length or customization of wall padding.

Do you want all of the walls padded? No Yes

Wall Dimensions:
Wall 1:

Wall 2:

Wall 3:

Wall 4:

Do you want door(s) padded? No Yes

Resilite will need a schematic or rough drawing of the room if you want a wall or all of the walls padded. This does not have to be in scale but Resilite will need all of the exact dimensions. Include door ways, windows, pilasters, fire extinguishers, phones, water fountains and any other obstacles. Please include the dimensions of the obstacles. Please fax the schematic to (570) 473-8988, e-mail to resilite@resilite.com, or mail to Resilite, Attn: Wall Padding Quotation, PO Box 764, Sunbury, PA 17801. If you have any questions, please feel free to call Resilite at 800-THE-MATS.

Wall Padding Information:

Choose from Three Types of Wall Padding

Kwik-Stik Permanent Wall Padding


	Padding Height : Wall Padding Color: Border Color: (free)

Wainscot Panels

Conventional Installation Style	OR	Slot-Back Installation Style
Guardian Conventional Guardian XL Conventional Duoguard Conventional Safeguard Plus Conventional (18 oz fabric only)		Guardian Slot-Back Guardian XL Slot-Back Duoguard Slot-Back Safeguard Plus Slot-Back (18 oz fabric only)

Size:		2' Wide Panel Quantity: 4' Wide Panel Quantity (for logos):

14 oz. Vinyl Fabric	OR	18 oz. Vinyl Fabric
14 oz. Mat Color :		18 oz. Mat Color :
2nd Alternating Color : (no charge)		2nd Alternating Color : (no charge)

Dual-Purpose Folding Mats

(V3) To Hang on wall & Velcro® mats to eachother on three sides	OR	(V4) To Hang on wall & Velcro® mats to eachother on all four sides
Elementary Folding Mats (V3) Senior Folding Mats 1 3/8" (v3) Senior Folding Mats 2" (V3) Tumbler Folding Mats (V3)		Elementary Folding Mats (V4) Senior Folding Mats 1 3/8" (v4) Senior Folding Mats 2" (V4) Tumbler Folding Mats (V4)

Select Coordinating Velcro Mat Hangers to hang Dual-Purpose Folding Mats.
Quantity:		Mat Color :
Size:		2nd Alternating Color : (no charge)
		3rd Alternating Color : (additional charge)


Custom Optional Features

Customize your mat with lettering and/or logos for an additional charge.

Lettering

Would you like your wall padding customized with lettering? No Yes

Lettering to be Applied:
Typestyle/Font Preference:
Lettering Color:
Lettering Color Outline: (only appropriate for 1to 3 letters)
Location of Lettering:

Logos

Place your school logo or insignia on wall padding. Resilite will need to see the image of the logo before an order is made. Logo pricing is based on size and number of colors used in the logo. A standard 4' - 6' logo with two colors generally costs about $250.00. (price subject to change without notice)

Would you like your Wall Padding customized with a logo? No Yes

Logo Size:	Standard 4' - 6' Logo (adjusted to fit on wall padding/wall panel) Oversized 7' to 10' Logo Oversized 11' to 15' Logo Note: Oversized logos can only be applied on Kwik-Stik Wall Padding. A logo must be wider in proportion than in height. The height of the logo will still remain 4' to 6' but the width will be oversized.
Logo Description: (ie. bulldog, eagle,etc)
Logo Location:
Colors of Logo: Give all of the colors that is required to create the logo. If the logo uses one of the colors in the mat, include that color as well. (ie. White bulldog with Black Lines. Collar: Lt Gold)

		PO Box 764 • Sunbury, PA 17801 Phone: 800-THE-MATS • 800-843-6287 Fax: 570-473-8988 • e-mail: resilite@resilite.com