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Please fill out the form below.
We will get back to you as soon as possible. Please feel free
to contact us at +1 760 945-4231. Thanks! |
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| Name: |
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Position: |
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| Address |
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Telephone: |
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Fax |
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E-mail: |
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| ZIP
Code: |
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Website: |
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| Sales
Channels (please specify) |
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# of storefronts |
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# Outside Sales Reps |
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SQ FT of storefronts |
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Online store |
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# of employees |
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Years in Business
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Catalog (yearly quantity) |
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Other (specify) |
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| Product Line Of Interest |
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Zoen Personal Air Purifier |
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Air-Aid Professional Air Purifer |
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Customer
Base |
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Personal Use |
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Professional Use |
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Health Care |
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Police/Tactical |
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Travel |
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Fire |
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Industrial |
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Medical
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Military |
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Other |
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Other |
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| Other
types of products you carry? |
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Do you
currently sell any other air purifiers?
If so, please specify. |
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| Price Range
of Other Air Purfiers Sold: |
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$
Lowest |
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$
Highest |
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| Average
Inventory on Hand
(please
specify) |
$
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| Level
of Inventory Interested in Carrying per Year (please
select one) |
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< $1,000
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$5,000 |
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$1,000 - $2,499 |
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$5,000 - $9,999 |
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$2,500 - $4,999 |
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over $10,000 |
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| Do
you require drop shipping? (please
note there is a $2.50 fee per address) |
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Yes
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No |
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| How did you hear about Noah Systems?
Please specify. |
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Trade Show |
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Online |
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Magazine |
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Other |
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Referral |
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| Additional Comments |
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