Platypus Technologies Distributor Application
This is the distributor application for Platypus Technologies. Please complete and submit. A Platypus Staff member will review and then contact you.
COMPANY INFORMATION
Date *
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Company Name
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Street Address
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City
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State/Province
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Postal Code
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Country
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Phone Number
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Email Address
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CONTACT INFORMATION
Point of Contact Name
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Position Within Company
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Email Address
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Phone Number
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SHIPPING INSTRUCTIONS
Street Address
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City
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State/Province
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Postal Code
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Country
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ANTICIPATED SALES
Order Frequency
Estimated Annual Order
Additional Comments
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PRODUCTS
Platypus products you are interested in adding to your portfolio (choose all that apply)
SALES FORCE
Number of sales people on staff
Primary Sales Method
TERRITORIES
Which territories are you currently distributing to?
List the countries within this territory that you are distributing to
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COMPANY SIZE
Number of accounts
Number of distribution hubs
Annual Revenue Last Year
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Annual Revenue Two Years Ago
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Annual Revenue Three Years Ago
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OTHER PRODUCTS
Complimentary Products (Compared with Platypus)
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Competing Products (Compared with Platypus)
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