Magnet Paints - Request for Information

We thank you for your interest in Magnet Paints. Please fill in the form below and don't forget the question fields so we can better understand your needs. Your catalog, price list and color selector will be mailed promptly and arrive in a few days.

NOTE: If you enter your email address incorrectly (missing the "@" or ".com" or ".net" etc) you may get an error message. Your request will still go through. Please DO NOT hit the Send button again. If you have any questions please send an email directly to info@magnetpaints.com

First Name

Last Name

Company Name

Address

City

State

Country

Zip / Postal Code

Phone Number

Fax Number

Email

It is helpful for us to know how you found our Web Site... (check all that apply):

	Magazine Advertisement
	Please specify:
Please enter the code from the bottom corner of the ad:
	Search Engine:
	Other:

What do you paint?

How many trucks, cars or pieces of equipment do you plan to paint in the next 6 months?

1 - 3
4 - 9
10 or more
None

Business Profile (please check all that apply)

	Individual
	Farm Owner (end user)
	Construction Company (end user)
	Refinishing Shop
	Manufacturer
	Distributor for Resale
	Other

What brands of paint do you currently purchase?

What Colors do you use?

Please send us your Comments

Please send Full Color Catalog, Price List, and Color Selector

Please have a salesperson call

Are Your Needs:

Immediate
1 - 3 Months
6 - 12 Months
Reference Only

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