SPECIFICATION REGISTRATION

To ensure that we properly and promptly award specification credit. All information must be accurate and complete to qualify for specification credit.

Date

MM

DD

YYYY

Agent Company

Contact Name

First Name

Last Name

Office Location

PROJECT INFORMATION

Project Name

Distributor

Location/ City/ Branch

SPECIFIER INFORMATION

Specifier Company

Specifier Contact

(###)

###

####

Location/ City/ Branch

Check if specifier is an:

Architect

Lighting Designer

Engineer

Interior Designer

-----

Buyer's Name

First Name

Last Name

Installation Location (City/State)

Approximate Date of Purchase

Approximate Value at Dealer Net

Please provide a complete list of catalog numbers and descriptions with quantities and spec types.

Specified Fixtures

Additional Information

Spec Registration

SPECIFICATION REGISTRATION