DISTRIBUTOR / RESELLER APPLICATION
Please make sure to answer all the questions as accurately as possible in order for us to properly assess a potential distributorship with your company.
Name/Title:
A) COMPANY & MARKET OVERVIEW
1) PROFILE :
Company Name:
Address:
City/Postal Code:
Mailing Address (if different from above) :
Country:
Phone:
Moblie:
Email Address :
Fax:
Web site address :
Names of Key Personnel :
Managing Director/General Manager:
Director of Marketing:
Director of Sales:
What year did your company begin operations? :
What geographic territory can you handle? :
2) Please provide a brief history of your firm:
3) Please check your type of business:
Retailer
Agent
Distributor
Manufacturer
Other
5) What type of products are you currently promoting, selling or servicing?
Supplier Name
Product
B) POWERBRIGHT PRODUCTS
1) Check the product lines you are interested in distributing:
12 Volt Power Inverters
24 Volt Power Inverters
Pure Sine Wave Inverters
Voltage Transformers
Voltage Regulators
Plug Adapters
Battery Chargers
Surge Protectors
Thank You! We will reply to you shortly.