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

Please supply as much information as possible:

Yes, Please send me a brochure
Fireline Wildland Brush Fire Qty
King Cobra Fire Fighting Hoods Qty		 Flame Resistant Clothing Qty
Name:
Date: 
Company:
Address: 
PO Box: 
City: 
State: 
Zip:
Country: 
Phone: 
Fax: 
E-mail: 
Please check all that apply:
Your Title:
Fire Chief
Assistant/Deputy Fire Chief
Battalion Chief
President/Commissioner
Secretary/Treasurer 		Fire Marshall
Training Officer
Fire Fighter
Captain/Lieutenant
EMS Coordinator
Other 

I have additional questions. Please have a company representative contact me at the above phone number.

If you have a few moments, the following questions would greatly assist us in our market/advertising efforts. However, we also realize your time is valuable and now may not be convenient. If this is the case, feel free to scroll down to the bottom of the page and click on "Submit". We thank you for your interest in PGI and will quickly forward the requested information.

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
Through Distribution
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

Comments:

 

Thank you for your time!!