If you are a retailer that is interested in any of the product lines that Grosfillex has to offer, please complete the form below. A Grosfillex Sales Representative will be in contact promptly.

If you are in the hospitality, restaurant or institutional business, please contact the Grosfillex Contract Furnishings Division.

Company Name*

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Title*

Salutation*

First Name*

Last Name*

Street Address*

City*

State*

Zip*

Phone*

Fax

Email*

Website

Type of Business* Pool & Patio Fireplace & Patio Furniture Store Designer Distributor Department Store Mass Retail Catalog Hardware Store Internet Retailer Nursery/Garden Center Supermarket Other

Number of Locations

Product Line Interest Garden Planters Utility Shelving Decorative Shelving Patio Furniture

How soon would you intend to purchase? Within 1,3,6 months 12 months

How did you hear about Grosfillex? Trade Show Magazine Internet Referred Other etc

What other product lines do you retail?

Type the code shown