HGH Supreme Privileges
2005 Opt-In Form

You must fill out and submit this form AND spend more than $2000 in any calendar month in 2005 to be included in this year’s program! NOTE: if you opted in for 2004, you are still opted in for 2005.

Fields with * are required.

Company Name:*  
Customer Number OR 
Order Number:*  
 Customer Number:
Previous Order Number:
Contact Name:*  
Phone:*  
 (ex: 800-123-4567)
Fax:  
Email:  

*You must opt-in this year to be included in Supreme Privileges. You will not receive points, however, until you qualify for the program by spending $2000 with HGH in one calendar month. Once you have opted-in AND qualified, you will receive points for the remainder of the calendar year.

YES! I would like to opt-in and be included in Supreme Privileges 2005!

No, I would like to opt-out, due to company policies.

No, I would like to opt-out for another reason (please specify):

WARNING: If you OPT OUT, then your points will not be made available to you, and you will not be able to redeem them for any of the above awards or any others in the program. You have nothing to lose by opting in!

Number of employees in your company:
N/A (homeowner or hobbyist, for example)
1-2 employees
3-5 employees
6-15 employees
16-24 employees
> 25 employees

Indicate your primary and secondary business descriptions:

Primary

Secondary

  
Custom Cabinet Maker
Kitchen Dealer
Builder/Contractor
Commercial Millwork/Casework
Stock Cabinet Manufacturer
Designer/Decorator/Architect
Wholesale Supplier/Reseller
Hobbyist/Homeowner/Misc Retail
Fixtures & Displays
Other/Misc
FOR CABINET SHOPS ONLY

Average kitchen job size:
Under $5,000
$5,000 - 10,000
$10,000 - $25,000
Over $25,000

You sell primarily to:
Homeowner
Contractor/Builder

Do you have a formal showroom, or other display area for your hardware?
Yes
No

Would you like to receive our quarterly sales flyer?
Yes
No