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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.

Company Name :*
Your Full Name :*
Email :*
Phone Number :*
Country :*
Please provide a brief history of your firm :
Please check your type of business :
- Retailer
- Agent
- Distributor
- Manufacturer
- Other
What type of products are you currently promoting, selling or servicing?
Supplier Name
Product
Supplier Name
Product
Supplier Name
Product
Supplier Name
Product
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
Sales Volume :

Corporate Office:

20423 State Rd 7 Suite F6-466 Boca Raton, FL 33498

USA Warehouse:

2016 Corporate Drive Wilmington, NC 28405 U.S.A.

Canadian Warehouse:

140 Rue Merizzi, Montreal, QC H4T 1S4, Canada

Toll free:

1-866-295-6775
Tel.: 954-603-4950
Fax: 954-603-4930

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