Use this form to request additional literature for
FireLine™ and King Cobra™ Fire Fighting Hoods.

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Yes, Please send me a brochure
Fireline Wildland Brush Fire Qty
King Cobra Fire Fighting Hoods Qty		 Sawbuck Chainsaw Chaps
Flame Resistant Clothing Qty
Name:
Date: 
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Your Title:
Fire Chief
Assistant/Deputy Fire Chief
Battalion Chief
President/Commissioner
Secretary/Treasurer 		Fire Marshall
Training Officer
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Type of department:
Volunteer/Paid-On Call
Combination Paid/Volunteer 		Industrial/Institutional
Military/Federal
Population served by your department:
Under 5,000
5,000 - 9,999
10,000 - 24,999
25,000 - 49,999 		50,000 - 99,999
100,000 - 249,999
250,000 - 999,999
Over 1 million
Purchasing Responsibility (either sole or as part of a committee):
Purchase
Recommend 		Specify
Approve
I prefer to purchase:
Directly with the manufacturer
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If through Distribution:
My Current Distributor for protective clothing is:
I read the following publications:
Fire Engineering
Fire Chief
Fire House
National Fire and Rescue		 Fire Fighters News
Public Safety Product News
Government Product News
Other
I first learned about or became familiar with PGI, Inc. through:
Advertisement
Trade Show
Through a distributor		 Referral by colleague or friend
On the Internet
Other

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