After you complete
and submit this form, you will receive an email to verify your information. Once we receive your
reply, we will activate your listing. Any listing not verified within 10 days will be deleted and
will require a new submission. Please complete all fields unless otherwise noted and use Title
case where appropriate. All entries received in all uppercase letters will be ignored, so make sure
caps lock is off.
Please complete all fields unless otherwise noted and use Title case where appropriate.
All entries received with any fields in all uppercase letters will be ignored.
Your Company Name (example: Mobile Goodies)
Your Name (First, Last)
Title
Address 1 (example:123 Voltland Ave.)
Address 2 (optional)(example:PO Box 123)
City (example: Mandeville)
Province/State
Zip Code Postal Code (example: 70012 or Rm 102 N)
Country
Email (example: the12volt@the12volt.com) If updating an existing entry, please use the same email address you used in your previous entry.
Phone (example: 504-555-5555)
Toll Free (optional)(example: 800-555-5432)
Fax (optional)(example: 504-555-1234)
Web Site (optional) (example: //www.the12volt.com)
Number of Locations
In Business Since
Began Installing
Brief Bio/Description (Please tell us about yourself in 1000 characters or less.)
Entries submitted with any field in all UPPERCASE letters will be ignored!
Disclaimer:*All information on this site ( the12volt.com ) is provided "as is" without any warranty of any kind, either expressed or implied, including but not limited to fitness for a particular use. Any user assumes the entire risk as to the accuracy and use of this information. Please
verify all wire colors and diagrams before applying any information.
