Country Lane Gazebos
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Dealer Application

Please fill out the following form if you are interested in becoming a Dealer of Country Lane Gazebos.

* Indicated required fields

1. Company Information

Full Name: *
Company Name: *
Street Address: *
Street Address 2:
City: *
State: *
Zip: *
Lot Location:
Office Phone: *
Cell Phone:
Fax Number:
Email Address: *

2. Business Survey

Do you currently sell Gazebos? * Yes   No
If yes; how many years?
If yes; have you sold wood, vinyl, or both?
If yes; who has been your supplier?
Do you have your own delivery service?
What other Products do you sell?
How long have you been in business?

3. Questions or Comments
Dealer Login | Become a Dealer
Address: 191 Jalyn Drive, New Holland, PA 17557
Phone: (717) 351-9250 - Toll Free: (877) 429-3262 - Fax: (717) 351-9248 - Email: info@countrylanegazebos.com
© 2010, Country Lane Gazebos. All Rights Reserved.