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Distributor Inquiry Form

Yes, I am interested in selling a financially rewarding and unique brand of products.

Tell us more about your company and your current product line:

Company Name:
Contact Name:
Street Address:
City:
State:
Zip:
Country:
Telephone:
Fax:
E-mail:
Website:
Primary Market Served:
Primary Products Sold:
Number of Product Lines:
Path to Market %:	Internet: Catalogue: Telephone Orders: Salespeople: Retail:
Estimated Annual Sales:

One of our owners will be in contact with you soon. We appreciate your interest in becoming an Authorized Selling Partner.

For more information, contact us at:

Gremlin Supply Corporation

326 Osborne Road

Loudonville, NY 12211

Phone: (518) 436-3700
Fax (518) 436-3800
email: sales@peejs.com

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