Potential New USA Distributor Questionaire

Please fill out and submit the form below. We will promptly get back to you. Thank you.

You may also send your responses by e-mail to info@doublekindustries.com. To download a PDF form you can fill out, save and send to us as an email attachment click here.

You may also fill out the .pdf form, print it and return by fax to 818-886-0218.

Contact Info      
* Distributor Name: * Date:
* Distributor Address: * City:
* State: * Zip Code:
* Contact Name /Title: * Email Address:
* Phone: Fax:
Website Address    
About your company  
* How Many Years Has Your company been in business?
* Does your company warehouse stock?
Number of other locations
* What product categories does your company sell?
Other Addresses if applicable
Sales & Advertising        
Does your company have sales reps? Yes No How many inside: Outside:
Does your company mail a flyer or catalog? Yes No How many pages?  
How many are mailed? How Often/Scheduled?
What percentages of your company's sales are in the following markets?
Equine % Veterinarian % Pet Grooming %
Kennels % Ranch & Farm %    
Other (specify) %  
Dunn & Bradstreet account number  
Does your company have a Dunn & Bradstreet account number? Yes No
Acct. #
Do you currently do service work/repairs on any of our products? Yes No
If not would you be willing to do repairs on our products? Yes No
Please explain briefly your technical capabilities:
Other Notes:
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