Jeremie Corp. || Handcrafted, Original Products ||

To receive our newest product catalog, please fill out and submit the following form.

Current Customers
You need only fill in those blanks with an asterisk (*). Then click on submit. You’ll receive your catalog in approximately one week.

New Customers
Please fill out the entire registration form below and click on submit. Then, simply fax your business license and resale tax number to Jeremie at 404.875.8660, adding a note that you have requested a catalog online. Once we have received both your request and your business license/resale tax number (Canadian customers, your GST number), we will forward a catalog to you.

* denotes a required field.

Catalog Request
* Your Name :
* Company Name :
Customer Number :

* Street Address :
Suite/Dept # :
City :
State :
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Zip :

* Telephone : ex. 555-555-5555		Ext :
Fax :
* E-Mail Address :


Federal ID # :
Tax Resale # :

What kind of business do you have :
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If 'other' please state where :
Would you like to receive e-mail notification of product specials?