Ridgefield Supply Company
29 Prospect Street
Ridgefield, CT 06877
www.ridgefieldsupply.com

BECOME A DROP OFF POINT

REQUIREMENTS:
Your company must be an independent Lumberyard located in North America.  F.B.F.R. is going to be opening pick-up points in stages, starting in the Northeast.  We hope to be nation wide by April 2006.   Please fill out the following information.  If you have any questions please don’t hesistate to contact us.

*required fields
Company Name
*Contact Name
Address
Address Line 2
City
State	Please Select ------------ Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ------ Armed Forces(AA) Armed Forces(AE) Armed Forces(AP) ------ Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territory Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
Zip Code
Phone Number
*Email Address
Comments/Questions
All company information will be for the private use of F.B.F.R. and will not be ‘sold’ or ‘given’ to any other organization.