Castle Autochem Products
Canadian Distributor Information Request Form
Name:
Address:
City:
Province:
Postal Code:
Daytime Phone:
Email Address:
How many sales persons in your operation?
Who is your primary market?
List the corresponding percentage range for all that apply.
Automotive Dealers/Repair Shops:
Less than 10%
10%-50%
More than 50%
Choose Percentage
Fleet Sales:
Less than 10%
10%-50%
More than 50%
Choose Percentage
Detail Shops:
Less than 10%
10%-50%
More than 50%
Choose Percentage
Industrial:
Less than 10%
10%-50%
More than 50%
Choose Percentage
Janitorial:
Less than 10%
10%-50%
More than 50%
Choose Percentage
Institutional:
Less than 10%
10%-50%
More than 50%
Choose Percentage
Recreational Vehicle:
Less than 10%
10%-50%
More than 50%
Choose Percentage
Other:
Less than 10%
10%-50%
More than 50%
Choose Percentage
Do you currently carry competitive product lines?
Yes
No
If so, which one(s)?
