email

company name

address

line 2 (optional)

city

country

United States United Kingdom China Afghanistan Albania Algeria Andorra Angola Antigua & Deps Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Central African Rep Chad Chile Colombia Comoros Congo Congo (Democratic Rep) Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea North Korea South Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar (Burma) Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russian Federation Rwanda St Kitts & Nevis St Lucia Saint Vincent & the Grenadines Samoa San Marino Sao Tome & Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Yemen Zambia Zimbabwe

tax id

company size

select one <$1M $1M-$10M $10M-$50M $50M-$100M $100M-$500M >$500M

seller type

select one Retailer Manufacturer Brand Distributor Other

How did you hear about The Grommet?

select one

Online advertising LinkedIn Media or news article Google Alert Existing Partner Referral (colleague / industry) Social Ad RangeMe Trade group or organization Trade show Other

Are you interested in exploring an exclusive partnership with The Grommet?

select one

Yes No

website

How would you classify your product/s?

category

select one Audio & Photo Gadgets Pets Safety Tech Accessories Travel Art Decor Food Games Jewelry Kids (+ Baby) Men's Accessories Stationery Toys Women's Accessories Garden Gear Grilling Health Outdoor Living Personal Care Sports & Fitness Bar Bed & Bath Cleaning Hydration Kitchen Cookware/Serveware/Prepware Kitchen Food Storage/Organization/Preservation Kitchen Gadgets/Appliances/Tools/Specialty Kitchen Textiles Laundry Office Tools & Home Improvement Philanthropy Unassigned

When did the product/s come to market?

approximate date

How many direct competitors do you have?

number of competitors

In what stage of development is your product/s?

select one

Prototype First stage manufacturing run Retail ready

Where are you manufacturing?

locations

Funding type

select all that apply

Self-funded from personal balance sheet Self-funded from business operations Friends and family angel capital Crowdfunding Venture Capital (equity) Accelerator or Incubator grants or equity investments Government grants Business competition prizes Bank or venture debt

Does your product or brand fall under one or more of the Grommet values?

select all that apply

Made in the USA
Your products are 100% American-made, creating jobs and opportunities for local communities. Social Enterprises
The greater social good is part of your business plan. Like providing practicing fair trade or implementing a buy-one, give-one policy to your business model. Underrepresented Entrepreneur
Your business is run/product invented by someone who identifies as any of the following; a woman, a veteran, minority, or person under the age of 18 or over the age of 65. Sustainable Living
Product is either produced using sustainable manufacturing practices or helps consumers live in a more sustainable way and reduce their carbon footprint. Small Business Support
Small Independent Business or Manufacturer

Who are your other major distribution partners?

select all that apply

Amazon Target Bed, Bath & Beyond Food52 Uncommon Goods Walmart Touch of Modern Etsy Huckberry HSN QVC Ace Hardware The Home Depot Lowes Primarily independent brick & mortar retailers

Do you have a MAP pricing policy in place with your other online retailers?

select one

Yes No

Do you currently warehouse your product/s in the USA?

Please note: this does not include Fulfillment by Amazon (FBA).

select one

Yes No

Are you able to drop ship individual units directly to customers?

select one

Yes No