Product Request Form

We are thankful to get requests for our products and for those who have used our products in their writings, photographs, videos, movies and promotions.

In an effort to better serve these requests, we ask that you complete the form below so we can have a better understanding of who you are, who you represent and how our products will be used and represented.

Customer Contact Information

First Name *

Last Name *

Company Name

Email Address *

Daytime Phone *

Complete Shipping Address

Product name, model and quantity requested:

How did you first learn about our products?

What will our product(s) be used for?

In what media formats will our product(s) be shown?

How can we access completed work of our product(s)?

Please, reference any previous projects for review including social media accounts, published works, websites, etc:

Please share Facebook active links with statistics of followers, views, rates, etc.

Please share Instagram active links with statistics of followers, views, rates, etc.

Please share Twitter active links with statistics of followers, views, rates, etc.

Please share YouTube active links with statistics of followers, views, rates, etc.

Please share other active links with statistics of followers, views, rates, etc.

Other comments

Submitting this completed form will give us the basis for making a decision. On occasion, additional information for clarity will be required and sought. The more information we have on you, your organization and intended efforts, the better.

Thank you for your product request submission which will give us the basis for making a decision. Should we require additional information, we will contact you. Most decisions are made within 5 business days.

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Customer Contact Information

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B&T Industries, LLC

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