MINIMIS - Become a Representative.
If you are interested in becoming a MINIMIS-authorized representative, kindly complete the form below.
YOUR NAME *
YOUR COMPANY NAME *
YOUR ROLE / TITLE *
WHAT COUNTRY ARE YOU LOCATED IN? *
YOUR TELEPHONE NUMBER *
YOUR EMAIL ADDRESS *
YOUR GROSS ANNUAL DEALER REVENUES? (INDICATE CURRENCY) *
WHAT BRANDS OF LIGHTING DO YOU CURRENTLY DEAL IN? *
WHAT IS YOUR AVERAGE MONTHLY MARKETING BUDGET? (INDICATE CURRENCY) *
WHAT IS YOUR GEOGRAPHICAL DEALER TERRITORY? (LIST COUNTRIES, PROVINCES OR STATES) *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.