New Supplier Request

If you would like to become a supplier to HarbisonWalker International, please complete the form below. An HWI employee will get in contact with you if we feel there are any opportunities.

New Supplier Request

Contact Information

First name*

Last name*

Job title*

Phone number*

800/secondary phone number

Fax number

Email*

Company Information

Company name*

Address*

City*

State/Province*

Zip Code*

Country*

Web address*

---

Most recent year annual sales (USD)*

Number of employees*

Less than 100 100 to 500 500 to 1,000 More than 1,000

Year company started*

Type of company*

Manufacturer Distributor Agent

---

Has your company done business with HWI in the past?*

Yes No

Which goods or services does your company supply?*

Raw Materials

Refractory Finished Goods

MRO (Maintenance, Repairs, Operating Supplies)

Industrial/Corporate Services/Consulting

Packaging Supplies/Pallets

Transportation

OtherOther

Please list details of good or services supplied in the comments section below*

Additional comments