Geneva Manufacturing (South Elgin, IL)

For information on becoming a dealer, please complete the following form:

Contact Information:
Company Name:
Contact Person:
Title:
Company Address:
City, State, Zip:	,
Phone:
Fax:
Email:
Business Information:
How are your sales conducted?	Online Physical store location Both (Online and physical store location)
What type of products do you currently carry?
How long have you been in business?	less than 1 year 1-5 years 5-10 years 10-15 years 15+ years
How many physical store locations do you have?
If more then one, please list the city and state in which your other locations are located. Please list each location on a seperate line.
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