Amana Dealer Inquiry

Amana Dealer Application
Todays Date*

MonthDayYear
Company Name*
Johnstone Supply Account #
Company Owner's/Principle's Name*

First NameLast Name
Is the contact person filling out this form different from the owner of the company?

YesNo
Name of the person filling out form*

First NameLast Name
Title in the company *
Contact phone number*
Please enter a valid phone number.
Contact email*
example@example.com
Company Address (No PO Boxes)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How many employees do you have in your company?*
Current Primary Unitary Brand *
Current Primary Ductless Brand*
2024 Residential HVAC Equipment Purchase Total*
2025 Residential Projected HVAC Equipment Purchase Total*
Amana Advantage Dealers are required to purchase and install a minimum of $75,000 of Amana residential HVAC equipment over a twelve month period. Daikin ductless purchases made through Johnstone Supply NJ/PA can be combined with a dealer's Amana equipment purchases to qualify.
Please confirm that you agree to these terms.*

Yes, I agree with the termsNo, I do not agree witht the terms
Should be Empty:

Amana Dealer Application