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CONTACT INFORMATION
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Name:
Title:
Company:
Phone Number:
Fax Number:
E-Mail Address:
Website Address:
Mailing Address:
City:
State / Province: (if inside U.S.A.)
Postal / Zip Code:
Country: (if outside U.S.A.)
BACKGROUND & PREFERENCES
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Years in Business:
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1 Year or Less
2-3 Years
3-5 Years
5-10 Years
10-15 Years
15-20 Years
20 Years or More
Preferred Territory:
- PLEASE INDICATE REGIONS, STATES OR COUNTRIES -
Preferred Product Line:
- PLEASE SELECT ALL THAT APPLY -
Portable Modular Buildings
Environmental Control Units
Custom Metallic Enclosures
Current Principals:
(Complete list of all Companies you currently represent)
- PLEASE INCLUDE WEBSITE ADDRESSES FOR EACH LISTING -
Bebco Response Method:
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Please call me to discuss this inquiry
Issue via E-Mail
Issue via Fax
Issue via Postal Mail
NOTES & COMMENTS
Please paste or type in information regarding your interest in
marketing our Products, including details about your Company and local Clients you now call on.
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FILE ATTACHMENTS
Please attach all relevant documents, including line sheets, territorial maps and
company information that may be useful for our evaluation.
Total size of all files may not exceed 5 Megs
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File Number 4:
File Number 5:
FORM SUBMISSION
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Thank you very much for this inquiry, and please expect a prompt reply!
4725 Lawndale - La Marque, Texas 77568 - U.S.A.
Phone: (409) 935-5743 Fax: (409) 938-4189
Business Hours: 8 a.m. to 5 p.m. CST, Monday-Friday
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Latest Update: 05.09.10
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