RapidRoc Application 2026
Please complete the following application. All information will be held in strict confidence.
Company
Street
City
State
Zip Code
Website Address
Primary Contact - First Name
Primary Contact - Last Name
Primary Contact - Position
Cell Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Business Phone
Please enter a valid phone number.
Format: (000) 000-0000.
E-mail Address
example@example.com
Years Business Experience
Year Business Founded
Primary Business
Are you incorporated?
Yes
No
State of incorporation
Are you a registered contractor?
Yes
No
State Registered
Number of employees
Employees dedicated to construction
Employees dedicated to sales/marketing
Number of locations
Warehouse
Yes
No
Warehouse Square Footage
Retail Store
Yes
No
Retail Store Square Footage
Area Currently Served
Residential vs. Commercial
Concrete Installations
Yes
No
Concrete Installations - # Jobs per Year
Concrete Experience
Flatwork
Walls
GFRC
Outdoor Living Installations
Yes
No
Outdoor Living Installations - # Jobs per Year
Outdoor Living Types
Outdoor Kitchens
Firepits
Seating
Water Feature Installations
Yes
No
Water Feature Installations - # Jobs per Year
Water Feature Types
Poolside
Pond
Stand-alone
Primary Source of New Leads
Secondary Source of New Leads
Percentage of gross revenue reinvested back into marketing
Social Media Presence
Company Site
Facebook
YouTube
Google+
Twitter
Other
Web Media Methods
PPC
SEO
Approx. 2025 Revenue
Expected 2026 Revenue Growth
Approx. Company Net Worth (Assets minus Debts)
Total Available Lines of Credit
Source of Funds to Pay for Tools and Materials
Primary Interest in Becoming RapidRoc Installer
Secondary Interest in Becoming RapidRoc Installer
Date submitted
-
Month
-
Day
Year
Date
Submitted by
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