Become a Kinetics Representative Please fill out the following form as completely as possible.
Firm Name:
Mailing Address 1:
Mailing Address 2:
City/Province:
State:
Country:
Zip Code:
Phone Number:
- - Ext.
Fax Number:
- -
Email Address:
Territory:
Desired Markets:
Number of Offices:
Number of People with Firm:
Outside Sales:
Inside Sales:
Support Staff:
Warehouse:
PRINCIPLES:(Please list and identify if active or inactive in the firm.)
1.
ACTIVE INACTIVE
2.
3.
4.
SALES FORCE RESUME: Please be prepared to submit a sheet with the following information for each inside and outside salesperson.
FIRM ANNUAL SALES: (Begin with current year-ending)
Year $ Year $ Year $ Does firm have a warehouse? Yes No Sq. Ft.? Could firm maintain KNC inventory? Yes No Does firm do assembly? Yes No Does firm do light manufacturing? Yes No
Year $ Year $ Year $
Does firm have a warehouse? Yes No Sq. Ft.? Could firm maintain KNC inventory? Yes No Does firm do assembly? Yes No Does firm do light manufacturing? Yes No
Key Consultants: Please identify if you have an active or inactive relationship with the following and mark N/A for the markets not applicable.
Acoustical: Architectural: Mechanical: Industrial:
Key Customers:
General Contractors: Mechanical Contractors: Industrial Plants:
Current Lines: Please submit current line card
1. 2. 3. 4. 5. 6. 7. 8. 9. 10.
Has the firm had experience with any other noise control or vibration isolation company? (Please list affiliation and time frame.)
Firm specialties and strengths:
I believe this information to be correct and complete Name:
