Dealer Application
1. Company Status: Startup Existing (If startup skip to question 8)
2. Company Name:
3. Company Registration/Licenses Held:
4. Date Established:
5. Number of Employees:
6. Federal & State Tax ID:
7. Main Activities of Company:
8. Contact Persons Name:
Position:
9. Address:
Country:
10. Phone:
Fax:
Cell:
11. E-mail:
Web:
12. Please outline why you want to become an Apricus dealer?
13. What skills do you/your company have which will allow you to effectively complete this role?
14. Do you have access to skilled mechanics who can be training to complete the installations? If so how many and what are they qualifications?
15. Who are the main solar companies (if any) dealing in your area?
16. Do you have the ability to complete solar hot water system designs? Please provide examples of any systems you may have designed and installed (not necessary solar thermal).
Name: Date: