Distributor Application

Distributor Application Form

Tell us about you

Your Name(Required)

First Last

Your Email Address(Required)

Email Address Confirm Email Address

Position or Title

Phone(Required)

Your Company(Required)

Your website

Trading name (if different)

Year business founded

DUNS number

Number of locations

Number of employees

Your Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

vi. Who would be the primary contact for receipt of marketing materials and pricing?

Are you applying to be a stocking distributor? (Please select all that apply):(Required)

Reseller - not stocking

Distributor - not stocking

Distributor - stocking

Other

If you selected "Other," please explain:

What types of products do you currently sell(Required)

Do you currently sell Temperature Measurement Equipment?(Required)

Yes

No

Do you currently sell Calibration/Metrology Equipment?(Required)

Yes

No

If you indicated yes above, what kinds of products do you sell?

What area/region/territory do you market and sell to the most?

List the top three products which are currently sold by your company:

Which of our products are you interested in selling?

What types of products do you currently sell?

How do you plan to market and display our products?

Anticipated initial order size? ($USD)

In which range to your gross annual sales fall?(Required)

iv. How do you market your represented products?(Required)

Do you participate in any trade exhibitions?(Required)

Yes

No

If yes, specify these exhibitions and whether you exhibit or attend.

Who would be the primary contact for receipt of marketing materials and pricing?

Name

First Last

Title

Phone

Email

Customer and Vendor Trade References

Max. file size: 256 MB.

Reseller Certificate (required for US)

Max. file size: 256 MB.

W9:

Max. file size: 256 MB.

Additional Comments

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Post Custom Field