{if $show_thanks}

Dealer Inquiries


Thank you,

Your dealer inquiry has been sent. A representative will contact you momentarily.

If your quote request is urgent call 1-518-218-7676

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{/if} {if $show_form}

DEALER INQUIRIES

Interested in becoming an authorized dealer of our products?
Please complete the form below or call us directly at 1-518-218-7676.


{if count($errmsg) > 0} Some errors were found. Please correct these errors and submit the form again.

{/if} {* 2009-08-03 commented out captchas *}
  * - required field
* {if $errmsg.company != ''} Company {else} Company {/if}
* {if $errmsg.first_name != ''} First Name {else} First Name {/if}
* {if $errmsg.last_name != ''} Last Name {else} Last Name {/if}
Street
* {if $errmsg.city != ''} City {else} City {/if}
* {if $errmsg.state != ''} State {else} State {/if} {literal} {/literal}
* {if $errmsg.zip != ''} Zip {else} Zip {/if}
* {if $errmsg.country != ''} Country {else} Country {/if} {literal} {/literal}
* {if $errmsg.phone != ''} Phone {else} Phone {/if}
* {if $errmsg.email != ''} Email {else} Email {/if}
* {if $errmsg.distribute_countries != ''} Which product(s) do you wish to distribute? {else} Which product(s) do you wish to distribute? {/if}
* {if $errmsg.distribute_countries != ''} Desired Territory? {else} Desired Territory? {/if}
  Comments/Questions
   
{if $errmsg.captcha != ''} Re-type the text shown below: {else} Re-type the text shown below: {/if}
   
    Verification is used to prevent SPAM
   
        
   
{/if}