Distributor Qualifying Form

Thank you for your interest in becoming an IPA Distributor: Please complete the IPA new distributor questionnaire. The information you provide is considered confidential, and will be utilized to qualify new distributors and to build the optimal marketing program to maximize your potential sales with the IPA line.

Step 1 of 2

Name

This field is for validation purposes and should be left unchanged.

Company Name(Required)

All DBA and Affiliated Names(Required)

Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Warehouse/Store Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Please Provide Contact Information for Owner and Shipping Manager

Number of Employees(Required)

What Products Are You interested In?

Please select some of the products you are interested in selling.

If Other, please list products:

Do you employ outside sales personnel? If Yes, how many:

Do you utilize tote and promote sales opportunities and promotions?

Do you utilize telemarketing?

Describe Your Business in 1 or 2 Sentences:(Required)

What is your path to market?(Required)

We sell direct to end-users

We are a WD who sells to a distributor who resells to end-users

We are a Manufacturer

Please check all that apply and add any comments you feel necessary.

Do you have a brick and mortar or physical location where you sell to walk-in customers?

Upload Image of Warehouse or Retail Establishment(s)(Required)

Drop files here or

Max. file size: 114 MB.

Do you accept warranty returns or advise customers to contact manufacturers directly?

Do you want to stock or drop ship IPA products?

Do you plan on selling through Ecommerce?(Required)

Yes

If yes, please answer the following two questions.

Ecommerce direct to end-user on our website or any affiliates website

Do you intend to sell ecommerce 3rd party Amazon, Walmart or other

If other please list

ListCorporate Website

List any alternative or affiliates websites where you plan to promote or sell IPA's products

Provide examples of current or past marketing pieces your company has used to promote other product lines

Drop files here or

Max. file size: 114 MB.

Would you like to make an accounts on IPATools.com?

Yes

Creating an account now will make ordering in the future easier if approved.

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