Brochure Request Form

Please fill out this form for a brochure and press the submit button at the bottom.

How often do you entertain (excluding holidays)?

1 or more times per month
At least 4 times a year
Less than 4 times a year

Do you own a Fondue Pot?

Yes
No
Would like one

Have you ever used a Hot Stone?

Yes
No

Do you enjoy Wine?

Yes
No

Where did you here about us?

Another Website
Magazine
Friend
Brochure
Trade Show

Please provide the following contact information:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
FAX
E-mail

Copyright © 2001 [Hot Stones of North America]. All rights reserved.
Revised: 05/10/03