* Indicates a required field

Name: *

Business Name:

Street Address 1: *

Street Address 2:

City: *

State: *

Zip: *

Phone: *

Ext:

Email: *

Do you have a brick and mortar store? * 

 Yes    No   

Do you sell products online? * 

 Yes    No   

Are you solely selling online? * 

 Yes    No   

How long has your company been established? * 

 0-1 Years     1-5 Years     Over 5 Years

What type of products are you interested in selling? * 

   Cutting Boards

   Commercial Tables

   Kitchen Carts

   Restaurant Dining Tops

   Sinks

   Other

Do you have a warehouse to stock and ship from? * 

 Yes    No   

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Important Note: The information you provide is preliminary and is not considered an application for becoming a dealer. All awards of becoming a dealer must be approved in writing or phone from our Customer Service Manager and must undergo a thorough evaluation process. John Boos & Co. does not assume any obligation of liability for any costs you may incur in preparing or submitting any information to John Boos & Co. Any action taken by you concerning this information should be done at your own risk, peril and liability.