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Contact Information
Name*:
Job Title: Company*:
Address*: Address 2:
City*: State/Province*:
Postal Code*: Country:
Phone*: E-Mail*:

ISA Specifics
How would you characterize your market coverage*?
(check all that apply) 		Local/Metropolitan
State
Regional
National
Please specify locations you cover*:
(i.e. cities and/or states)
Which vertical markets do you sell to*?
(check all that apply) 		Distribution (food, retail)
Finance
Healthcare
Insurance
Legal
State & Local Government
Transporation
Other:
What products/solutions do you currently sell*?
Legal structure of your business*:
Please describe your overall sales and marketing strategy*:
Please post your resume here *
(Microsoft Word document ONLY)
Number of years you've been in the business:
What companies do you currently sell for?
Number of sales reps in your organization:
Number of customers you currently have:
Comments:

Please note: After our initial phone call with you, we will send you a copy of our Independent Sales Agent agreement for you review.

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22 November 2008 | Copyright iComProducts International
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