1.- First Name *

2.- Last Name *

3.- Company Name *

4.- Your Title/Position with company *

5.- Your e-mail *

6.- Phone Number - Include area code *

7.- Fax

8.- Business Address *

9.- City *

10.- State/Province *

11.- Zip/Postal Code *

12.- Country *

United StatesCanadaMexico

13.- Company Website. Don't have one? Enter SigmaFertilizers.com *

14.- Our Rep Company has been in operation since the year *

15.-How many sales representatives does you company have. Inside/Outside?*

16.- Approximate Number of active customers*

---Over 10Over 30Over 50Over 100Over 200Over 300Over 500

17.- Please list your sales territories *

18.- How many product lines do you carry? List them.*

19.- What do you know about our fertilizer products?*

20.- What do you know about the markets where our products are sold?*

21.- Do you sell fertilizers, soil amendments or complimentary products similar to our product line?*

---YesNo

If Yes, please list them*

22.- Are you familiar with Coco Coir / Coco Peat?*

---YesNo

If Yes, please explain*

23.- Do you see potential sales of Coco Coir / Coco Peat products in your territory?*

---YesNo

If Yes, please explain*

24.- Important. Do you know if fertilizers and soil amendments require registration in your territory? Don't know? click Yes and write Don't know*

---YesNo

If Yes, please list the states. If don't know, please pick YES, find out and let us know. Thank you*

25.- How do you manage leads?*

26.- What kind of training would you expect from us?*

27.- Why will you be successful with our line?*

28.- What percentage of commissions (Gross Sales) are you looking for? For new business and repeat orders*

Comments and/or additional information you wish us to consider

Thank you.

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