Inhibitor Contact Us

GENERAL BUSINESS INFORMATION
* required information
Business Name:	*	NAICS/SIC:
Owner(s) Name:	*	Years in Business:		*
		Retail Square Footage:		*
Mailing Address:	*	Number of Employees:		*
Mailing City:	*	Store Hours:		*
Mailing State:	*	Bank Name:		*
Mailing Zip:	*	Bank Contact:		*
	(if different)	Bank Phone:		*
Shipping Address :		Business Reference One
Shipping City:		Contact Name:		*
Shipping State:		Phone:		*
Shipping Zip:		Business Reference Two
Business Phone:	*	Contact Name:		*
Business Fax:		Phone:		*
Email Address:	*
Website URL:

BUSINESS INFORMATION
Place a check in the box next to the category of products that you sell in your store:
	Hunting Gear		Farming Equipment
	Firearms and Ammunition		Lawn and Garden
	Clothing and Footwear		Automotive
	Archery Equipment		Motorcycles/ATVs/Snowmobiles
	Fishing Tackle		Boating/Marine Equipment
	Camping Gear		Military Gear and Equipment
	Sports Equipment

Indicate which 3 comprise the largest part of your sales:
	Hunting Gear		Farming Equipment
	Firearms and Ammunition		Lawn and Garden
	Clothing and Footwear		Automotive
	Archery Equipment		Motorcycles/ATVs/Snowmobiles
	Fishing Tackle		Boating/Marine Equipment
	Camping Gear		Military Gear and Equipment
	Sports Equipment

Indicate which you DO NOT currently carry, but are interested in carrying in the future:
	Hunting Gear		Farming Equipment
	Firearms and Ammunition		Lawn and Garden
	Clothing and Footwear		Automotive
	Archery Equipment		Motorcycles/ATVs/Snowmobiles
	Fishing Tackle		Boating/Marine Equipment
	Camping Gear		Military Gear and Equipment
	Sports Equipment

How did you hear of The Inhibitor Rust Prevention System?

Call us at 1-877-INHIBIT (877) 464-4248

Van Patten Industries
P.O. Box 6694
Rockford, IL 61125