Dealer Inquiry - Int'l

Hydro-Photon, Inc., the makers of SteriPEN, the fastest growing portable water purifier on the market, is always looking for strong distributors internationally carrying compatible product lines to represent our products. If you are interested in becoming a distributor please fill out the following questionnaire below and click 'Submit' button at bottom.

Company Name

Company Contact *

Position in Company

Email Address *

Company Address

Company Address 2

Company Address 3

City

State/Province/County

Country

Postal Code

Telephone *

Fax

Website Address

Questions

Retail store

How many locations

Internet/online store

Website address

Catalog

Number mailed

When do you mail them

Discounter

Government agencies

End users/consumers

Other

Please specify

Other

Please specify

Markets that you cover (please check all that apply):

Travel

Outdoor

Travel medicine

Pharmacy

Disaster preparedness

Emergency first response

Other

Please specify

Other

Please specify

Product lines carried

How many years in business?

How many customers do you have?

Are they retail accounts? Yes No

Do you sell directly to the end user Yes No

What territory and/or countries do you cover?

Do you have a rep force Yes No

Number of reps

What is our company's annual revenue in local currency?

How would you market SteriPEN and to whom would you market it?

What are your top reasons for wanting to represent our products?

Do you have packaging requirements that we should be aware of? Yes No

If yes, what are the packaging requirements?

Are there import regulations that could cause difficulties for our product class?

If yes, please tell us what the import regulations are.

Please provide two bank references: contact names, telephone numbers, and email addresses:

Please provide any further information that you would lke to tell us:

Dealer Inquiry - Int'l

Questions

SteriPEN Technology

Climbing Kilimanjaro

WQA Approved

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