Wholesale/Sales Agent Sign-up Form

Please complete the form below and our sales manager will contact you regarding distribution or sales agent opportunities.

Company name:

Address:

City:

State/Province:

Country:

Zip Code:

Phone number:

Fax:

Website address:

# of years in business:

# of product lines represented:

Business territory:

Type of business registration?

Corporation

Partnership

Sole proprietorship

Other

Type of business conducted?

Importer

Stocking Distributor

Retailer (Brick & Mortar)

Catalog

Website

Sale Representative

Markets served:

Emergency Preparedness

Recreation

Environmental

General Retail

Non Profit

Military

Other

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