Glendon Biofilter Technologies: License Request

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	License Request

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* Required items

Company Name*:

Address*:

City*:

State Zip*:

Phone number*:

Fax number:

E-mail Address*:

Owners*:

Name	Title/Function	% Owned

Years experience in
on-site system industry*:

Number of Employees*:

List all on-site licenses currently held*:

List all industry related companies
you have ever been or are currently
associated with as an employee,
representative or dealer and dates
of affiliation*:

Name(s) of persons to be licensed and
type of license, installer or O&M*:

Approximate number of designs and/or
installations you accomplish each year*:

Glendon_® designs and/or installations
you anticipate in the first year*:

Two industry references
(names and phone numbers)*:

Two credit references
(names and phone numbers)*:

If we accept your application we will send you a license for you to review and complete prior to receiving training. After successful completion of training, your name will be posted on our web site and your license will be active in accordance with its terms and conditions.

Thank you for your interest in Glendon_®.

Home The Glendon_® Story Testimonials The Glendon_® Difference Request Information Contact Glendon_® Designer/Installer Site

P.O. Box 2585
Gig Harbor, WA 98335

General Inquiries: info@glendon.com
Tech Support: t_suppt@glendon.com