Distributor Application

Thank you for your interest in distributing ABI’s products. Applications for the 2014 term will be accepted until Friday, November 1, 2013. You must submit this form for us to consider you for distributor status with ABI.

We will review your application after this date, and you will be notified via email if you have been selected to become a distributor.

If you have any questions, please contact distributor@abionline.com.

(required) = Indicates required field

Company Data

COMPANY NAME (required)
(Please enter the name of your organization.)

STREET ADDRESS

ADDITIONAL STREET ADDRESS (Apt, Suite, etc.)

CITY

STATE

ZIP CODE

COUNTRY

WEBSITE

COUNTRIES SERVICED (required)
(Please list the countries you are able to distribute our products in.)

YEAR FOUNDED
(In what year was your organization founded?)

VAT OR TAX ID NUMBER (required)
(Please provide your VAT or government tax ID number. This will aid in delivering shipments to you efficiently.)

DUNN & BRADSTREET NUMBER
(Please enter your Dunn & Bradstreet number, if available.)

ESTIMATED 12-MONTH SALES OF ABI PRODUCTS
(Please estimate the amount of purchases of ABI products over the first twelve months.)

ANNUAL COMPANY SALES VOLUME (required)

TYPE OF BUSINESS (required)

WHAT MARKETING STRATEGIES WILL YOU IMPLEMENT TO SELL OUR PRODUCTS (required)
(e.g., cold calls, etc.)

WHICH ABI PRODUCTS ARE YOU MOST INTERESTED IN DISTRIBUTING? (check all that apply) (required)

WHAT OTHER TYPES OF PRODUCTS DO YOU SELL (required)

Primary Contact

Use this area to provide information for ABI's primary contact at your organization regarding distributor communications. This will not be published publicly.

CONTACT NAME (required)

EMAIL (required)

PHONE NUMBER (required)

FAX

Information for customers

Information below will be published on our website for our customers' convenience.

EMAIL (required)

PHONE (required)

LOGO (required)

Additional Comments

Please add any any additional comments below.