Become A Distributor

Company Name and DBA if applicable *

Headquarter Location (complete address): *

Name *

First

Last

Position

Email *

Company’s phone number: *

Website

Location *

Accounting Manager contact information (name, email address and phone number)

Sales Manager contact information (name, email address and phone number)

Number of sales representatives:

Purchasing Manager contact information (name, email address and phone number)

Areas of distribution you currently cover *

Type of items you currently distribute *

Are you interested in the full line of products or just a few items? *

The full line of products

Just a few items

What is the nature of your business (Wholesaler, Retailer, End User)? *

If you wish to import our products, do you have a freight forwarder in your country