Please provide the following information in order for us to provide you with more information on our ConstantColor® CMH® Integral PAR38 Lamp and determine if you qualify for a free trial!

* = Required Information
CONTACT INFORMATION
* First Name: 
* Last Name: 
* Company Name: 
* Title: 
* Industry: 
* Address: 
 
* City: 
* State: 
* Zip Code: 
  Phone Number:  (ex: 555-555-5555)
* E-mail Address: 
  GE Account Manager: 


LIGHTING INFORMATION
Number of Stores: 
Number of Incandescent or Halogen PAR38 Lamps Used per Store: 
How would you describe your role in the purchase decision of your companies lighting solutions? 
 
Where did you hear about this offer? 
 
 

Disclaimer: Requests are subject to approval at the discretion of GE Consumer & Industrial; we reserve the right to determine what constitutes a "qualified respondent". Kits will be distributed on a first-come-first-serve basis to qualified respondents. To qualify you must be a decision maker in your company's lighting procurement, currently use Incandescent or Halogen PAR lamps, and have over 1000 sockets. These qualification requirements are subject to change. We will ship to commercial addresses located in the United States or Canada ONLY, so please no residential or PO Box requests. Limited quantities are available. Limit one sample kit per company. Not for resale.