WHOLESALE CATALOGUE
REQUEST FORM

1. Your Information

* Required Fields

e-mail address must be given
for us to process your request.

Company Name :
Address * :
City * :
State :
Zip/Postcode :
Tax ID * :
Telephone * :
Fax :
Person To Contact  * :
Title :
E-mail
Address *
:
URL :

E-mail address must be given or we
will not be able to reply to your requests

Please tell us what type of business you are in :

Import Export
Manufacturing Wholesale
Mail Order Retail Shop
Chain/Department Store Not Yet
Auction

Other type of business (please specify) :

2. Product Details

Please tell us what types of products you are interested in:
Seagrass, Woven Furniture Indian Furniture
Reproduction Furniture Chinese Furniture
Colonial Style Furniture Chinese Accessories
Teak Garden
Painted / Whitewash Venetian Mirrors

How soon do you plan on buying :
ASAP 3 months
6 months Don't know

Would you like to receive notification of
updates to our Catalougue and web site:
Yes No

Please tell us what type of Operating System do you use:
:
Windows 3.5 Macintosh OS 9
Windows 95 Mac OS X
Windows 98 Unix / Linux
Windows NT Web TV
Windows XP Other

Could you plese tell us how you found our web site:
Search Engine
Catalogue Yahoo.com AOL.com
Trade Show Altavista.com MSN.com
Friend Google.com Hotbot.com
Other Looksmart.com Excite.com

Other comments / information :