Dealer Signup

July 7, 2011 at 8:44 am

Contact Information
First Name: *	required
Last Name: *	required
E-mail: *	required
Phone: *	required
Fax:
Home Address *	required
City: *	required
State:
Zip Code: *	required
Country *	required
How did you hear about the dewpointe®? *	required
Company Information
Company Name:
Company Type:	Corporation Proprietorship Partnership
Is this an existing business?	Yes No
If “Yes,” will the Atmospheric Water Systems Distributorship be part of this business?	Yes No
Company Address:
City:
State:
Zip:
Country:
Officer/Proprietor name & title:
Business Email:
Business Phone:
Business Fax:
Years in Business:
Anunual Revenue:
Current Website:
Proposed Distributorship Name:
Proposed Web Address:
Business Experience
Include all relevent business experience: *	required
Please list three trade references: *	required
Sales & marketing Information
Requested Territory *	required
Requested Vertical/Industry Marketing Territory: *	required
Please describe your plans to market dewpointe atmospheric water generators: *	required
How many sales people do you currently employ?
Inside Sales:
Outside Sales:
Will the dewpointe be marketed along with your existing products?	Yes No
If “No,” who will be selling the dewpointe?
Physical Plant Information
Do you have an existing office/showroom/warehouse facilities?	Yes No
Office Size(sq. ft.):
Warehouse Size(sq. ft.):
Showroom Size (sq. ft.):
Other facilities:
Comments
Please include any comments, questions or plans for a dewpointe distributorship.

Sales
sales@aws-h2o.com
866-857-5074

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