Black Bear Product Submittal Form

Company Contact Information

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* 1. Please provide the full name of a point of contact with whom we can communicate regarding product testing.

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* 2. Please provide a contact phone number for product testing communications.

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* 3. Please provide an email address for product testing communications.

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* 4. Please provide the full legal name of your company:

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* 5. What is the mailing address for your company?

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* 6. In what city is your company located?

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* 7. In what state or U.S. territory is your company currently headquartered?

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* 8. What is your 5-digit zipcode?