Business to Business Inquiry Form

We ARE interested in becoming a Firestik® customer. Please,

 Send information relevant to our business operations.
 Call us about days after the information is sent.
 Call before sending information. We have some questions.

Name:
Company:
Street:
City: State:
Country Postal Code:
e-mail 800 number:
Biz Phone: Biz FAX:

SELL INSTALL SERVICE
CB radios/accessories
Amateur radios/accessories
Cellular phone/accessories
Marine radio/accessories
Business radio/accessories
Scanners and accessories
Does your business do mail-order sales? Yes
Does your business do internet sales? Yes
Does your business have a Home Page? Yes

What is the URL of your Home Page?  

If you sell CB antennas, what are your primary brands?
1.       2.       3.

List three (3) suppliers that you buy from directly:
    Supplier 1:      Location:
    Supplier 2:      Location:
    Supplier 3:      Location:

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