Application for Distributorship Form

Distributorship Form

"*" indicates required fields

1Company Information

2Sales Information

3Sales Representation

4Credit Information

5Preview

Name and Title: {Principal Contact Name and Title:9}
Phone: {Principal Contact's Direct Phone Number:10}
Email: {Principal Contact's Email Address:11}
Name and Title Officers or Owners: {Names and Titles of Officers or Owners:12}
Legal name and address headquarters parent company: {Legal Name and Address of Headquarters or Parent Company (principal place of business) (if applicable):13}
Geographic Concentration: {Geographic Concentration:14}
Primary Industries Served: {Primary Industries Served:16}
Primary Product Lines Distributed: {Primary Product Lines Distributed:19}
Distributor Type: {Distributor Type:17}

What CRM do you use?: {What CRM do you use?:24}
How do you track sales opportunities?: {How do you track sales opportunities?:25}
How do you show value?: {How do you show value?:26}
How do you track success stories?: {How do you track success stories?:27}
What is your annual sales commitment to NSK?: {What is your annual sales commitment to NSK?:28}
What percentage of sales is metalworking?: {What percentage of sales is metalworking?:29}
Do you require cost savings tracking of your salespeople?: {Do you require cost savings tracking of your salespeople?:86}
Will NSK be allowed to make joint sales calls with your personnel?: {Will NSK be allowed to make joint sales calls with your personnel?:87}
Are you interested in joint marketing success stories?: {Are you interested in joint marketing success stories?:88}

Company Legal Name and d/b/a: {Company Legal Name and d/b/a (if applicable):5}
Company Address: {Company Address (principle place of business):6}
Company Website: {Company Website:47}
AP Contact Name: {AP Contact Name:48}
AP Contact Phone: {AP Contact Phone:49}
AP Contact Email: {AP Contact Email:102}
Names and Titles of Officers and Owners: {Names and Titles of Officers or Owners:12}
Legal Name and Address of Headquarters or Parent Company: {Legal Name and Address of Headquarters or Parent Company (principal place of business) (if applicable):13}
Credit Line Requested: Yes
Credit Amount Requested: {Credit Amount:103}
Existing Customer: Yes
Federal ID Number: {Federal ID Number:52}
DUNS ID Number: {DUNS ID Number:55}
Years In Business: {Years in Business:56}
Description of Business: {Description of Business:57}
Type of Company: {Type of Company (Check all that may apply):58}
Invoice Billing Address: asdas
Preferred Method of Invoice Submission: {Invoice Billing Address:60}
Primary Ship to Address: {Primary Ship to Address:63}
Preferred Shipping Company: {Preferred Shipping Company:64}
Preferred Shipping Company Account Number: {Preferred Shipping Company Account Number:65}
Additional Ship to Addresses: {Additional Ship to Addresses (if applicable):66}
Exempt from Sales and Use Tax
Attachments: {Please attach copies of all applicable Sales and Use Tax Exemptions as well as the following documents.:68}