*PLEASE FILL AND PRINT OUT THIS
FORM AND FAX IT TO (212) 971-9564.
WE WILL PROCESS YOUR FORM IMMEDIATELY. THANK YOU.
Teen Much
CATALOG REQUEST FORM
NEW YORK SHOWROOM
350 FIFTH AVENUE
EMPIRE STATE BLDG., ROOM# 5773
NEW YORK, NY 11011
TEL: (212) 971-9234
FAX: (212) 971-9564
1. COMPANY NAME:
2. ADDRESS:
3. CITY:
4. STATE:
5. ZIP:
6. PHONE:
7. FAX:
8. EMAIL:
9. CONTACT NAME:
10. YEAR IN BUSINESS:
11. BUSINESS TYPE:
a. RETAIL b. WHOLESALE c. IMPORTER d. TRADING CO. e. OTHER
12. MAIN PRODUCT LINE:
13. MERCHANDISE INTERESTED IN: