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| 2. | Company Name: (Entire name as you would like it to be listed) |
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| 3. | Company Former Name (if applicable) |
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| 4. | Division or Subsidiary of: |
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| 5. | Company Street Address |
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| 6. | Company Mailing Address |
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| 11. | Telephone (If outside USA/CANADA, please include foreign access codes.) |
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| 14. | E-mail Address (As you would like to be listed) |
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| 16. | Who is your targeted audience, retailers and/or professional landscaper/pond builders? |
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| RETAILER PRODUCTS |
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| 19. | PEST & PREDATOR CONTROL |
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| 20. | CLOTHING/PROTECTIVE WEAR |
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FISH FOOD & SUPPLIES
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| 21. | FISH FEEDING IMPLEMENTS |
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| 24. | MEDICAL SUPPLIES & ACCESSORIES |
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GARDEN ART, GIFTS, ETC.
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| 35. | HYDROPONIC/AGUAPONIC SUPPLIES |
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PLANT/LANDSCAPING PRODUCTS
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| 37. | FERTILIZER, SOIL & PLANTING MEDIUMS |
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| 41. | LANDSCAPING MATERIALS |
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| 42. | POTS/BASKETS/CONTAINERS/PLANTERS |
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| 44. | STONE & ROCK (SYNTHETIC) |
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PLANTS, FISH & OTHER LIVE GOODS
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| 48. | INSECTS/INVERTEBRATES |
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POND EQUIPMENT
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| 54. | FOUNTAINS (ALSO SEE GARDEN ART SECTION) |
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| 57. | POND CLEANING TOOLS/EQUIPMENT |
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| 58. | PONDS, LINERS & SUPPLIES |
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| PROFESSIONAL LANDSCAPER/POND BUILDER PRODUCTS |
| 62. | CLOTHING/PROTECTIVE WEAR |
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FISH SUPPLIES & ACCESSORIES
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| 64. | MEDICAL SUPPLIES & ACCESSORIES |
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| 65. | PEST & PREDATOR CONTROL |
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| 68. | HYDROPONIC/AQUAPONIC SUPPLIES |
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| 69. | LANDSCAPE CONTRACTOR RESOURCES |
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PLANT/LANDSCAPING PRODUCTS
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| 72. | FERTILIZER, SOIL & PLANTING MEDIUMS |
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| 75. | LANDSCAPING MATERIALS |
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| 76. | POTS, CONTAINERS, ETC. |
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| 78. | STONE & ROCK (SYNTHETIC) |
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| 80. | PLANTS, FISH & OTHER LIVE GOODS |
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POND EQUIPMENT
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| 83. | FILTERS/FILTRATION MATERIALS |
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| 86. | POND CLEANING TOOLS/EQUIPMENT |
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| 87. | PONDS, LINERS & SUPPLIES |
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| 92. | Please check states and/or foreign countries covered by your personnel (Distributors and Manufacturers' Represenatives Only): |
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| 93. | President
(Optional/To enhance your listing) |
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| 94. | VP Sales
(Optional/To enhance your listing) |
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| 95. | VP Marketing
(Optional/To enhance your listing) |
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| 96. | Purchasing
(Optional/To enhance your listing) |
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| 97. | Media Contact
(Optional/To enhance your listing) |
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| 98. | Year Founded
(Optional/To enhance your listing) |
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| 99. | Name of your Distributor(s)
(Optional/To enhance your listing) |
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| 100. | Company Profile (20 words or less).
(Optional/To enhance your listing) |
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| 101. | Trade & Brand Names
(Optional/To enhance your listing) |
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| 102. | Applicant's Name/Name of Person Completing This Form |
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| 104. | May we contact you by fax? |
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| 106. | Contact E-mail Address |
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