International Distributor/Dealer Application


Corporation Type
Business Name:
Contact Name:
Address:
City: State, Zip: ,  
Country: Province:
Office Phone: Fax:
Email: Website:
Dealer Information:
Interested in becoming an International:   Distributor   Dealer
How many locations?
Service Sq Ft:  Showroom Sq Ft: 
What are you currently Selling?: 
Logistics:
Do you currently have a customs broker? Yes or No: 
Do you have a freight forwarder? Yes or No: 
Does your country ban imports from any specific countries?: 
What is the nearest port to you?: 
Have you imported product previously?: 
Comments:
Signature:  Date: