Inquiry Form Name* First Name Last Name Company name* Title / Function* Telephone*E-Mail* DemographicsPrimary business activity-- Please selectPlumbing, Hydronic Heating, HVAC/R ContractorWholesale, Distributor, Manufactuers AgentConsulting Engineer, Specification Writer, Builing ContractorSchools, Hospital, Hotel, Health Care and RelatedGovernment, Utilities, Energy ProviderRental CompanyOtherDistribution Commercial Residential Industrial Institution Other Please specify Number of employees 5 or less 6 - 10 11 - 50 51 - 100 101 - 500 501 and more Market share/sizeNumber of residential water heaters 1 - 1,000 1,001 - 10,000 10,001 - 25,000 25,001 or more Geographic areas servedCountry Canada United States Canadian Provinces Select All Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon US states Select All Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaï Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming We are listeningWhy am I interested in this product?Consent* I authorize Usines Giant Factories Inc. to use the enclosed information and to communicate with me for all inquiry associated with the ECOGRID® product. CommentsThis field is for validation purposes and should be left unchanged.