Fax Questionnaire

SUBJECT: Distributor/Licensee Questionnaire Facsimile

Your Company Details:

Company Name:

Date:

Street Address:

Postal Address:

Phone Number:

Fax Number:

Website Address:

E-mail Address:

Contact Person:

Position in Company:

Names of all Company Directors:

Number of Company Employees:

Make up, (i.e. external, admin etc):

Business References:

Ph:

Ph.

Personal References:

Ph:

Ph.

Annual Revenue (please tick appropriate box):
0 to $1M $1M to $5M $5M to $10M $10M and over

Do you have warehousing facilities: Yes No

If Yes, please describe product distribution capability:

What are your territory's geographical boundaries:

Who do you sell to: (eg, distributors, end users) Please include percentages.

How many active accounts do you have?

What product range do you sell?

What fundamental business philosophies do you adopt in your business?

Your Interest in Representing Us:

Why are you considering adding the Sign One product line to your product range:

Why do you think our product will sell in your country?

What are your clients' attitudes toward purchasing an imported product as opposed to a locally made equivalent:

As a prerequisite, what are your expectations of Sign One?

Your Marketing Strategy:

Your aspirations as to market share potential and/or achievable sales:

How would you go about achieving these aspirations:

Thank you for taking the time to complete this form.