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Get Listed as a Retailer<br />

Please fax this form to 815-895-1873.<br />

You can also complete the form online at www.provenwinners.com.<br />

We have registered in the past. Please<br />

update our record and the number of<br />

employees we want to certify.<br />

First Name __________________________________________ Last Name ________________________________________________<br />

Title _______________________________________________ Company ___________________________________________________<br />

Store Location Address __________________________________________________ Address 2 __________________________________<br />

City ____________________________________________ State/Province _______________________ Zip/Postal Code _______________<br />

Shipping/Mailing Address ________________________________________________ Address 2 __________________________________<br />

City ____________________________________________ State/Province _______________________ Zip/Postal Code _______________<br />

Phone Number ___________________________ Alternate Phone Number _______________________ Fax Number ___________________<br />

Company Email _______________________________________________________ Company Website_____________________________<br />

(for consumers)<br />

Even if you currently do not use the site, please provide your user name and password to gain future access to www.provenwinners.com.<br />

User name ___________________________________________________ Password _________________________________________<br />

Password should be 6-20 characters, letters and numbers only. No spaces please. Your user name and password ARE case sensitive.<br />

Keep this information for your records.<br />

Would you like to be listed on www.provenwinners.com as a retailer of <strong>Proven</strong> <strong>Winners</strong> products Yes No<br />

14<br />

Which <strong>Proven</strong> <strong>Winners</strong> plant products do you carry<br />

<strong>Proven</strong> <strong>Winners</strong><br />

<strong>Proven</strong> <strong>Winners</strong> Perennials<br />

<strong>Proven</strong> Selections <strong>Proven</strong> <strong>Winners</strong> ColorChoice<br />

Flowering Shrubs<br />

Which <strong>Proven</strong> <strong>Winners</strong> products do you use or carry<br />

<strong>Proven</strong> <strong>Winners</strong> and/or <strong>Proven</strong> Selections branded logo pots<br />

<strong>Proven</strong> <strong>Winners</strong> Premium Potting Soil<br />

<strong>Proven</strong> <strong>Winners</strong> Premium Time Release Plant Food<br />

<strong>Proven</strong> <strong>Winners</strong> Premium Soluble Plant Food<br />

<strong>Proven</strong> <strong>Winners</strong> WaterWise ® Kits<br />

iGarden Certification Training Program is a free program<br />

that consists of watching an online video or DVD and taking a<br />

test. In the program you will learn about the new and hot plants<br />

and what is available to help you sell <strong>Proven</strong> <strong>Winners</strong> plants.<br />

Number of employees you want to certify,<br />

including yourself.<br />

Total number of employees in company.<br />

Please select the electronic communications you would like to receive:<br />

What’s In Store Retailers Newsletter<br />

<strong>Winners</strong> Circle Newsletter (Home Gardener)<br />

<strong>Proven</strong> Beauty – Online Magazine (Home Gardener)<br />

Go to www.provenwinners.com/professionals/marketing-tools/proven-beauty-magazine-1<br />

to learn how you can add this online magazine to your own website.<br />

Monthly News for Growers Newsletter<br />

Would you like to receive a <strong>Proven</strong> <strong>Winners</strong> catalog and<br />

information on other <strong>Proven</strong> <strong>Winners</strong> Programs Yes No<br />

Will you be creating a <strong>Proven</strong> <strong>Winners</strong> Store-Within-A-Store this year<br />

using <strong>Proven</strong> <strong>Winners</strong> for P.O.P. Yes No<br />

In which months is your garden center open<br />

January May September<br />

February June October<br />

March July November<br />

April August December<br />

Which months do you generally carry <strong>Proven</strong> <strong>Winners</strong> products<br />

January May September<br />

February June October<br />

March July November<br />

April August December

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