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Custom Bullet Makers page
Download or print this form, complete and sign, and mail to Corbin in order to be listed as a custom bullet maker. If you are already listed, you can request changes by e-mail. We will need to confirm any substantial changes with the person signing the original consent form.

  	CUSTOM BULLET MAKER

  	Listing Consent Form

  	*************************

	By signing and returning this form with the requested information, 

	the custom bullet maker gives Corbin Manufacturing & Supply, Inc., 

	permission to publicly list this information on Corbin's internet web 

	page, to publish the information in Corbin's World Directory of Custom 

	Bullet Makers print edition and digital publications, and to refer

	callers to the telephone, fax, e-mail, street address and any other

	listed information in response to inquiries about custom bullet

	orders. While every effort is made to accurately list the information,

	Corbin Manufacturing & Supply, Inc., and its officers and employees

	are not responsible for any liabilities arising from errors in or 

	omissions from the list. The person giving consent to list agrees to 

	send revised information in writing immediately in the event of changes

	or discontinuation of business. Only the person signing the form can

	authorize future changes. In the event of ownership changes, the

	listing will be changed by permission of the original owner. 



	Agreed, by (authorized signature):


 	___________________________________________________

	

	On this date: __________________________



	LISTING INFORMATION:



	For digital listings, the following information is limited to the 

	number of characters in parenthesis, and any longer response will 

	be cut off at the character length indicated:



	FIRM NAME (30):________________________________________________



	STREET OR PO BOX (30):_________________________________________



	CITY (20):_______________________________



	STATE OR PROVINCE ABBREVIATION (4):______



	POSTAL CODE (10):______________



	COUNTRY (20):____________________________



	PERSON TO CONTACT (30):________________________________________



	TELEPHONE (10):  (___)___-____



	FAX (10): (___)___-____



	E-MAIL (30): __________________________________________________



	WEB SITE (30):_________________________________________________



	BULLET JACKETS OFFERED? (Yes/No): _____               



	LEAD WIRE OFFERED? (Yes/No): _____



	BULLET DIAMETERS (up to 10, 3 digits each):



 	____  ____  ____  ____  ____  ____  ____  ____  ____  ____