Registration Form - Palmita Warranty | Palmex International

1General client information

2Installer information

3Distributor information

4Project information

General client information
Full legal name (company, hotel, individual…)*
Contact person's full name*
Title
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Installed to an other address
- Installed to an other address
Address of location where the Palmex™ products are installed
Street Address City State / Province / Region ZIP / Postal Code Country

Installer information

This page is optional, you can skip it if you have no Installer information
Company legal name
Contact person's full name
Title
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Email

Distributor information

This page is optional, you can skip it if you have no distributor information
Company legal name
Contact person's full name
Title
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Phone
Email

Installation Guide Request Form

Please fill out the form below to have our digital catalog or installation guide emailed to you.
Name*
First Last
Company name*
Address*
Street Address City ZIP / Postal Code Country
Phone number*
Email*
Please email me the following*
- Products Catalog
- Installation guide
Email
This field is for validation purposes and should be left unchanged.