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1.Contact Information

  • Full Name:
  • Company Name:
  • Website (if applicable):
  • Email Address:
  • Phone Number:
  • Preferred Callback Time: (Specify timezone)

2. Local Business Information

  • Business Address:
  • Business Type: (☐ Manufacturer ☐ Distributor ☐ Retailer ☐ Other: ______)
  • Industry: (☐ Electronics ☐ Furniture ☐ Automotive ☐ Clothing & Textiles ☐ Food & Beverage ☐
  • Other: ______)
  • Do you have an import license? (☐ Yes ☐ No ☐ Not Sure)

3. Product Details

  • Product Name:
  • Quantity Required:
  • Target Price per Unit:
  • Tariff:
  • Preferred Supplier Location: (☐ China ☐ Vietnam ☐ India ☐ Other: ______)
  • Product Specifications:
  • o Material:
  • o Size/Dimensions:
  • o Weight:
  • o Certifications Required (e.g., FDA, CE, RoHS, etc.):
  • o Customization Required? (☐ Yes ☐ No) If yes, please specify:

4. Shipping & Logistics

  • Preferred Shipping Method: (☐ Air ☐ Sea ☐ Land ☐ Not Sure)
  • Destination Port/Address:
  • Do you need assistance with customs clearance? (☐ Yes ☐ No)

5. Additional Notes

  • Specific Questions or Concerns for the Call:

Callback form

Please fill out the form as specific as possible for us to better understand your need and assist you more effitiently

Chicago Warehouse Address

11056 Addison AveFranklin Park, IL 60131 See Our Stores

Information

+1 312-961-9688

contact@wizmodern.com