Grounds For Play, Inc.

U.S. Federal Government GSA Catalog Request Form

Please fill out the following form so that we can send you our latest catalog. Please note the required fields (including federal agency and region number). We would not be able to fulfill your request without their completion.

* Fed Agency Name:
* GSA Region Number:
Salutation:
* First Name:
* Last Name:
Title:
Company/Organization:
* Email:
* Phone:	(XXX-XXX-XXXX)
* Address 1:
Address 2:
* City:
* State:
* Zip:
Cell Phone:
Fax Number:

* How soon do you plan on making a purchase ?

0-6 months
6-12 months
more than a year

* What will this equipment be used for?

* Do you have an approximate budget?

What age group is this for?

* How many users will use this playground?

* Please select the products you are most interested in:
(select all that apply)

Innovative Playground Design
Outdoor Classroom
Outdoor Music Instruments
Surfacing (Wood Fiber, Poured In Place Rubber, Rubber Tiles, Artificial Turf)
Removable/Retractable Shades
Shelters and Pavilions
Benches and Tables
Other
Traditional Playground Equipment (i.e. swings, slides, climbers)

How did you hear about us?

Google
Yahoo
MSN/Bing
Other Search Engine
Client Referral
Received Mailing
Past Customer
Advertisement
Other