LED SMART Distributor Application Form

LED SMART Reseller Interest Form (2021)

If you are interested in distributing our products in your region, please fill in the form below to find out more about this channel partnership opportunity.
Company Name
Contact Name
Position
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Format: (000) 000-0000.
E-mail
Company Website
What is the nature of your business?

DistributionRetail/WholesaleOnline Retailer
Do you have any knowledge of our product line-up?

yesno
How do you sell your products?

Company Owned Store(s)e-commerceOutside/Inside SalepersonsSales Agency
Based on your experience, what is your expectation for our products annual sales?

below $300,000US$301,000US - $500,000$501,000US - $1,000,000USover $1,000,000
In case you are already distributing products, how many active customers belong to your customer base?

below 5051 - 100101 - 200201 - 300301 - 400over 500
Do you currently distribute or resell any lighting products for other companies? If so which ones?
Which LED SMART products are you interested in?
Should be Empty:

LED SMART Reseller Interest Form (2021)