Preferred Installer Registration

1. What type of business do you represent? 1. What type of business do you represent? Plumbing (Plumber) Security Home Automation Plumbing Wholeseller Builder/General Contractor Other (please specify in the next field)

Enter your business type here

2. Which best describes your role in your company? 2. Which best describes your role in your company? Owner/General Manager Administrator/purchasing Field technician

3. How many employees work in your office/operation? 3. How many employees work in your office/operation? 1 2-5 6-10 11-20 21 or more

4. Have you previously purchased or installed a FloLogic System? 4. Have you previously purchased or installed a FloLogic System? Yes No

5. Please share your business contact information: First Name

Last Name

Business Name

Street address

Street address 2

City

State StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonMarylandMassachusettsMichiganMinnesotaMississippiMissouriPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip code

Company website

Your Email

Company Phone

I would like to be added to your preferred installer list.

Please send me free sales support materials to provide to prospective customers.