Contact

Please complete the form below and we will get back to you.

If you don’t currently work with a distributor, our team will assist you in locating a qualified and knowledgeable distributor in your community.

Email
This field is for validation purposes and should be left unchanged.
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Lead Source–Hidden
This is a hidden field has a default value of “100000007” that allows us to flow this into the Lead Source field of Dynamics CRM and set it to “Website”.
This field is hidden when viewing the form
Salesforce Lead Status
Name*
First Last
Email*
Business Phone
Mobile Phone
Direct Phone
Company*
Company Website
Address*
Street Address Address Line 2 City ZIP / Postal Code
Lookup*
CountryState
Original Equipment Mfr. (OEM)
- Original Equipment Mfr. (OEM) – – Check box if Stat-X will be integrated into your product.
Industry*
Application*
Power Generation*
Power Generation*
This field is hidden when viewing the form
Industry–Final
This is a hidden field that takes the value of either Industry–Land or Industry–Marine in order to pass it through to Dynamics CRM Industry field.
How can we help?*
By giving us your contact information, you are giving consent to Fireaway Inc. to follow-up with you via email or phone. We will treat your data with respect and only share it with our distributor partners for the purpose outlined on the form.

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