Builder Program Form

If you're interested in joining Cooper Lighting Solution's Builder Program, fill out the form below and we will be in touch!

1. Builder Business Name *

Please enter your builder business name

2. First Name *

Please enter your first name

3. Last Name *

Please enter your last name

4. Job Title *

Please enter your job title

5. Email Address *

Please enter a valid email address

6. Business Phone *

Please enter your business phone number

7. Country *

Please select a country

8. Business address *

Please enter your business address

9. City *

Please enter your city

10. State or Province *

Please enter your state or province

11. Zip or Postal Code *

Please enter your zip or postal code

12. Number of residential units you expect to build this year *

Please enter a valid number

13. How did you discover the HALO Builder Program? *

Please choose how you heard about the HALO Builder Program

14. Name of preferred distributor *

Please enter the name of your preferred distributor

15. Distributor Contact *

Please enter the name of your distributor contact

16. Distributor Telephone *

Please enter the name of your distributor telephone

17. Distributor email address *

Please enter the name of your distributor email address

I agree to be informed regularly about Cooper Lighting Solutions products, promotions and news. I understand and agree that Cooper Lighting Solutions will use my data to personalize marketing communications. Any use of my personal data will take place in compliance with the relevant and applicable data privacy laws and the Cooper Lighting Solutions Privacy Policy. I can change my preferences at any time, or withdraw my consent by clicking on the relevant links in Cooper Lighting Solutions's email footers.