Parts HeadQuarters Inc

Distributor
Application
Form

The first step is to tell us about your company.  We would establish a working relationship based on your answers.  We would grant exclusivity dependent on the level of your  organizational expertise and initial success in selling our products.  Please share as much information as you feel comfortable with supplying.  The more you tell us about your company the better we will be able to work with you.

Company Name

Mandatory

Street Address

Mandatory

City

Mandatory

Province/State

Mandatory

Country

Mandatory

Zip Postal Code

Mandatory

Principal Contact Name

Mandatory

Email Address

Mandatory

Phone Number   Enter 10 digit number

Mandatory

Fax Number   Enter 10 digit number

Mandatory

Number of employees

  

Mandatory

Ownership of company

Mandatory

How long in business

   Years

Mandatory

 

FINANCE

Name of Bank

How long with Bank

  Years

Credit Terms Expected

  Days

 

MANUFACTURING

Do you manufacture products

  Yes          No

Mandatory

Provide list describing products presently marketed by you.

SALES-MARKETING
Sales Volume

Mandatory

Field Offices

  Number

Mandatory

Market segments


Hold Ctrl Key for Mulitple Choices

Mandatory

Three Major Customers

Competition in the Area


Hold Ctrl Key for Mulitple Choices

Mandatory

Web Site

COMMUNICATION

Accounting Software

Contact Software

Office Software

Email Software

 

Enter any additional comments in the space provided below:

Tell us how to get in touch with you:

Please telephone.  Reply by Email Mail Distributor Agreement

     13 May 2013 03:42:51 PM

Send mail to webmaster@partshq.com with questions or comments about this web site.       

Last modified: May 13, 2013

Copyright 1997 Parts HeadQuarters Inc. All rights reserved. Information in this document is subject to change without notice.
Other products and companies referred to herein are trademarks or registered trademarks of their respective companies or mark holders.