Prospective Distributor Questionnaire

Please complete this questionnaire as thoroughly as possible
so full consideration can be given to your suitability.


Please Note - We are only currently considering applicants for distribution in the following countries/regions:
  • Germany
  • Sweden
  • Finland
  • Norway
  • Poland
  • Italy
  • Kingdom of Saudi Arabia
  • India
    • New Delhi Region
    • Mumbai Region
    • Bangalore Region

COMPANY PROFILE:
Contact Name:
Company Name:
Address:
Telephone Number:
Fax Number:
Email Address:

Website Address:
Number of Employees:
Branch Offices/Warehouses:
Senior Executives: (Name, positions, and qualifications)
What is your present annual sales (U.S. Dollars)?:
Number of sales people: Outside       Inside  
What region/countries do you presently cover?

TOP 5 PRODUCT LINES AND PERCENTAGE OF TOTAL SALES:
1st % of Total Annual Sales Growing Declining Flat
2nd % of Total Annual Sales Growing Declining Flat
3rd % of Total Annual Sales Growing Declining Flat
4th % of Total Annual Sales Growing Declining Flat
5th % of Total Annual Sales Growing Declining Flat

COMPANY FOCUS: Please specify your Top 3 target industries or markets Key Applications in that market:
1st % of Total Annual Sales
2nd % of Total Annual Sales
3rd % of Total Annual Sales

PRIMARY PRODUCTS OF INTEREST:
Check all that apply		 ANTICIPATED SALES OF DWYER PRODUCTS:
Pressure Switches/Transmitters after 1 year.
Flow Switches/Transmitters after 2 years.
Level Switches/Transmitters after 3 years.
Temperature Controls/Transmitters  
Humidity Transmitters  
Valve Indicating Switches  
Valves  

OTHER:
What technical qualifications do your sales people have?
List of existing companies and products represented:
Do you have your own distribution transport? Yes    No
Would you appoint a DWYER specialist or product manager? Yes    No
Why should DWYER select you as a distributor, and future business partner?
What Trade Shows do you currently participate in?
What would be your plans to advertise, exhibit, and/or promote the complete DWYER product line?
Please list your bankers names and addresses and two other principle names from whom commercial references could be obtained.
 
This document does not constitute an agreement between the applicant and Dwyer Instruments, Inc. as a representative of DWYER products.
   

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