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First Name

Last Name

Email Address

Phone

Company Name

What is your business tax ID? (EIN #)

What is your sales tax exemption #? (if applicable)

How long have you been in business?

Shipping Address

City

State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIlliniosIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusetts'MichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip Code

Do you currently sell lighting? Do you currently sell lighting? Yes No

What kind of lighting do you sell? (brands, style, etc.)

Do you have multiple business locations? Do you have multiple business locations? Yes No

How many business locations?

Do you have a Tru-Scapes Sales Rep? Do you have a Tru-Scapes Sales Rep? Yes No

What is their name?

How do you sell products? How do you sell products? Brick & Mortar Store Online

What other products do you sell?

Do you have your own delivery service? Do you have your own delivery service? Yes No

Is there any additional information that you would like our team to know?