Group Order Request Form

Thank you for your interest in Landau Uniforms, the leader in premium uniforms for over 50 years. While we do not sell direct, if you are interested in placing a large order we are here to help! Please take a moment to complete the form below. A Landau representative will contact you within two business days.
Information about your inquiry:
* Required Fields
First Name:*
Last Name:*
Company Name:*
Industry:*
Address:*
City:*
State:*
Zip:*
Phone:*
Cell:
Email:*
Web:
About purchasing:
Are you selling to another company? If yes, please enter the company name:
Are you the decision maker for your company?
Yes No
If not, who is?
Number of professionals to be outfitted:
Who will wear the uniforms (select one or both):
Which are you seeking to outfit (select one)?
Please indicate which of the following you will need:
Yes No  - Scrubs
Yes No  - Lab Coats
Yes No  - Printed Tops
Yes No  - Embroidery
Yes No  - Non-Medical Professional Wear
Yes No  - Customization Services
Additional Comments: