Hargrove Hearth Products
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| Last Name: First Name: |
| Address 1: Address 2: |
| City: State: Zip Code: |
| E-mail Address: Telephone (optional): |
| Log Set Size, Burner, Valve Configuration & Gas Type: |
Size: Burner: Valve: Gas Type: |
| Name of Log Set, Log Style or Hearth Pad: |
Other: |
| Revolution Electric Log Set or Fireplace: |
Mantel: |
| How did you find out about Hargrove Gas Logs? |
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| Dealer's Name: Dealer's City: |
| What was your most important consideration in purchasing this product? |
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| Where will the product be installed? new construction an existing home |
| Is this the first set of gas logs you have owned? Yes No |
| Any comments or ideas you would like to share with us: |
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| PRIVACY STATEMENT: All information collected on this form is for the internal use of Hargrove Manufacturing Corp. and its dealers, and will not be sold or distributed to other parties. |
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Please report any problems experienced while using this form to: Hargrove Manufacturing Corporation |