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Product ID

Product Name

Quantity

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Personal details

We love to get to know who we are working with, as well as respect your time and privacy. We use this information as a primary point of contact, so we know who to reach out to for your business needs.

First name

Last name

Business email

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Phone

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Company address

Henkel requires your accurate company information as this greatly helps us in serving your specific needs in a timely manner.

Company name

Henkel uses a 3rd party lookup application to easily search for your company information. Start typing in your company name, and our form will provide recommendations to choose from. If you don't find your company, you will still be able to fill out the rest of the form.

City

Zip code

Specify the zipcode from your business address. This helps us service your business needs through our extensive remote/in-field sales & services teams.

Company details

Size of your organization

Specify the approximate number of employees in your organization within the US.

Market segment

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Additional details

Select your product

Your product

Quantity

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Anything else that we can help you with?

Provide any additional information that could be useful for us to know about your business and systems.

Communication preferences

We, Henkel Corporation would like to personalize our digital services, retail activities and online advertising based on an analysis of your interactions with us, our websites and services (as stated under read more), to provide you and the company you are representing, with the most relevant and interesting content.

In particular, we will analyze your use of (1) our newsletter and other e-mail advertisements, (2) our websites, as well as (3) your previous interactions with us, including inquiries and complaints you have issued and purchases you have made for your company, (4) your participation in online and offline events (either hosted by us or a third party), (5) your engagement with our online advertisements on our website as well as third party websites and apps, and (6) the publicly accessible information contained in your professional social media profiles, as well as anonymize any such information in order to enable further analysis of your interactions with us without being able to attribute any such information to you.

I agree to the analysis of my personal data as described above and I want to receive personalized digital content about Henkel Adhesive Technologies, including product offers and other communications via:

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E-mail

I want to receive the personalized newsletter and other e-mail advertisements from you, based on the analysis of my personal data as described above providing me with personalized and up to date information on all products and proposals in the field of adhesives relevant to me and/or my company.

Facebook and LinkedIn

I want advertisements for your products and events regarding adhesives shown to me on Facebook and LinkedIn to be personalized based on the analysis of my personal data as described above. My E-Mail address and/or my user ID will be transferred to Meta Platforms Ireland Ltd., 4 Grand Canal Square, Grand Canal Harbour, Dublin 2 Ireland and LinkedIn Corporation, 1000 W. Maude Avenue, Sunnyvale, CA 94085, USA for this purpose.

(Other) third party websites and apps

I want my experience of product offers, digital content and services of Henkel Corporation and online communication regarding its products and events, also on third party websites and apps, to be personalized based on the analysis of my personal data as described above. My e-mail address and/or my user ID will be transferred to marketing and advertising partners for this purpose.

You may withdraw your consent at any time with effect for the future, for example by managing your communication preferences or deleting your account in the user profile, or by clicking “unsubscribe” or as otherwise described in any of our websites, emails, push notifications or text messaging, as may be applicable to you.

By clicking Submit request, I agree to be bound by the Henkel Terms of Use. I also acknowledge and consent to the practices described in Henkel’s Privacy Policy and CA Privacy rights.

Please note that any changes made to this form will not be saved in your account. For updates to your information, please access your account directly.

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Additional details

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