Vestil Distributor Questionnaire

Company Name:

Address:

City:

State:      Zip:
      

Country:

Phone:

FAX:

E-MAIL:

Web Site (optional):

Sales Contact Name:

Number of Salesman:

Year Established:

Type of Distributor:

Primary Method of Selling Product:

Product Line Interested In (check all that apply):
Loading Dock Equipment Industrial Ergonomic Equipment Material Handling Equipment
Fork Truck Attachments & Hoppers Safety Equipment & Rack Guarding Drum Handling Equipment
Carts & Hand Trucks Warehouse Ladders

Do you have Warehouse facilities?  If yes, please describe distribution capabilities:

What are your territory's geographical boundaries?:

What is the primary Industry you sell to?:

Are you interested in custom imprinting supplement catalogs?:

Are you interested in distribution business cards listing your company as an authorized Vestil Manufacturing distributor?: