NBI Installer Technician Form
This form is to be completed by all window covering technicians interested in accepting referral work from NBI. Questions marked "*" must be answered.

Address
1. Company name *
2. First name *
3. Last name *
4. Street *
5. City *
6. State *
7. Zip *

Phone, etc. (e.g. 123-456-7890)
Check the small boxes for each number to be given to customers *
8. Home phone   8a.
9. Work phone   9a.
10. Mobile phone 10a.
11. Pager 11a.
12. Fax number
13. E-mail
13a. Confirm E-mail

Work Related
14. What best describes your role in the industry *
15. How far do you normally "book out" installation and
measuring appointments *
16. Would you object to a background screening check * No Yes
17. Have you been convicted of a felony * No Yes
18. Do you carry liability insurance * No Yes
19. Amount per ocurrence (number only -- for $500,000 enter 500,000) *
20. Are you required to be licensed by your state * No Yes
21. License #
22. How did you hear about NBI’s "Installer Referral" program *

References from accounts for whom you have recently completed installations
23. Reference #1 (name, address & phone/e-mail) *
24. Reference #2 (name, address & phone/e-mail) *
25. Are you willing to provide references to customers? * No Yes
26. Are you willing/able to receive freight (i.e. someone is at your location to sign)? * No Yes

Labor Pricing
Remember to include NBI's referral fees: $5/window covering -- see our Terms. (e.g. $15.00)
29. Pre-measure *
30. Minimum charge (installation charge when individual fees total less) *
31. Standard horizontal treatments (minis, wood blinds, cellular shades, etc ) * each
32. Vertical blinds * / linear ft
33. Sheer/soft verticals (HD Luminette, Bali sheer enchantment, etc) * / linear ft
34. Takedowns/removal * each
35. How many "Base" miles will you travel from home before an additional trip charge applies? *
35a. How many EXTRA miles will you travel if you are paid to do so (up to 2 x "Base" miles)? *

Experience & Knowledge
36. In what year did you start installing window coverings (e.g. 1997) *
Do you have experience with:
37. Commercial work * No Yes
38. Making templates * No Yes
39. Installing into concrete * No Yes
40. Work above 12 ft from floor * No Yes
41. Soft drapery (installing traverse rods, pinch pleated drapery, board mounted valances/cornices, rod pockets) * No Yes
42. Remote control/motorization * No Yes
43. Hunter Douglas products (e.g. Silhouette & Powerise, Luminette & Powerglide, Trio, Allouette) * No Yes

Plantation Shutters
44. Vinyl Shutters * No Yes
45. Real wood shutters * No Yes
46. Faux wood shutters * No Yes
47. MDF shutters * No Yes
48. Normans International shutters * No Yes
49. HD Heritance shutters * No Yes
50. Other
51. What is your approx. price per square to install shutters$

Formal Training
52. Certified to install HD’s Heritence * No Yes
53. Attended Hunter Douglas' 3-day installer certification class * No Yes
54. If yes, what is your HD installer #
55. Any other training

Other activities
56. Do you provide any service, other than those we have listed (including any outside the window covering industry)

NBI Application Terms
57. I have read and can comply with NBI's Technician Application Terms: *
58. I will comply with NBI's Rules of Contractor Etiquette *
59. I will provide NBI's Workmanship Guarantees to customers referred to me by NBI *
60. I will promptly pay NBI's referral fees (currently $5/window treatment installed) *