PlanterSpeakers dealer application

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Thank you for your interst in our products. Please provide the following information.

Include your company billing information here. We will collect your shipping address, if it is differennt, next.

Company Name

Street

Suite

City

State

Zipcode

Telephone

Billing Contact Name

Billing Contact Telephone

Billing Contact Email Address

Shipping same as billing address? Yes No

Include your shipping address here if it is different than your billing address.

Name

Street

Suite

City

State

Zipcode

Telephone

The shipping address Residential Commercial

Is there a loading dock at the shipping address? Yes No

Would you like to be listed on our website? Yes No

Please provide the following information if you would like to be included in our online dealer list. If you don't want a specific item, ie: your address, just leave it blank. We will use the information included here for the dealer listing, not the billing or shipping info.

Company Name

Street

Suite

City

State

Zipcode

Telephone

Website

Do you have a showroom Yes Yes, by appointment No

Are you a robot?

Thank you for your interest in PlanterSpeakers. You will receive an email confirming we have received your application. We will contact you after your applcation has been reviewed.

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Madison Fielding
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Contact:

Phone: (914) 939-9155
(9:00 AM - 4:30 PM EST Monday-Friday)
Email: contact@planterspeakers.com

PlanterSpeakers
540 Barnum Avenue
Bldg. 2 / Fifth Floor
Bridgeport, CT 06608