Retailer Application
* Required
Retailer Principal Name*
Company/DBA*
Street Address*
City*
State*
Zip Code*
Contact Name*
Email Address*
Retailer Web Address*
i.e.(www.website.com)
Phone Number*
Fax Number*
Years in Business*
Number of Employees*
Number of Locations*
What is your Primary Business Functions? (Please check one or more)*
Retailer
Architect
Outdoor Kitchen Builder
Resort
Other (please specify below)
Other
Industries Represented (Please check one or more)*
Hearth & Fireplace
Outdoor Furniture Accessories
Outdoor Grills & Ovens
Outdoor Kitchens
Pools & Spas
Outdoor Fireplaces
Cookware & Accessories
Patio Heaters
Other (Please Specify Below)
Other
Key Manufacturers* (Please list major manufacturers)
Additional Information (Please give us any additional information on your company and other comments you may have.)
