Partner Application

Contact Information

Company Name*

Address 1*

Address 2

City*

State*

Zip/Postal Code*

Country*

Phone Number*

Fax Number

Website

Comments

Owner Contact

Owner Contact*

Email*

Phone Number*

Fax Number

Purchasing contact is the same as the owner contact*

Yes
No

Accounts payable contact is the same as the owner contact*

Yes
No

Payment Preference*

Purchasing Contact

Purchasing Contact Name*

Email*

Phone Number*

Fax Number

Accounts Payable Contact

Accounts Payable Contact Name*

Email*

Phone Number*

Fax Number

Additional Contact

If you would like, you can add another contact for your company.

Additional Contact Name

Title

Email

Phone Number

Fax Number

Marketing/Communications

Anti-spam laws may affect our ability to send you electronic messages from Gemini, which include new product information, special promotions and invitations to programs and events. If you would like to receive these messages please check the following box.

Would you like to receive emails directly from Gemini?*

Yes, I'm OK receiving emails directly from Gemini
No, I do NOT want to receive emails from Gemini

About Your Business

Type of Business*

Business Location Type*

Number of Employees*

What is the focus of your business?

Check all that apply

If other, please specify the focus of your business*

Where do you get a majority of your business?

Check all that apply

Walk-in/Retail Location
Outside Sales Force
Division 10/Contractors
Architects
Website/Advertising
Other

If other, please specify where you get a majority of your business*

Select any of the Gemini marketing tools you would like from the options below

Sample Kit
Professional Signage Catalog (with pricing)
Showcase Catalog (no pricing)

Where did you hear about Gemini?*

Check all that apply

Trade show
Online search
Other

If other, please specify where you heard about Gemini*

Would you like us to contact you?

Yes, I'd like Gemini to contact me to discuss a project

Name

This field is for validation purposes and should be left unchanged.