Application to Become a Distributor Name of Company How many years in business under this name? Are you a division or subsidiary? If so, who is the parent company(s)? YESNO Associations and Memberships Mailing Address Website Address Telephone Fax Email Skype MSN Primary Contact (Purchaser) Secondary Contact (Accounts Payable) Current Number of Employees Please list the locations/countries that you plan on selling SOLARA products What types of certifications are required to sell in the listed locations/countries? Lighting Segments that you currently cover and approximate revenues in each segment: Commercial/Office Outdoors/Sports Facilities Private/Educational Facilities Governmental/Public Facilities Consumer/Residential Transportation - Roadway/Rail Size of warehouse/storage facility Do you currently recycle lamps containing mercury? YESNO Estimated Monthly Purchase Amount How much do you know about induction lighting? Practically Nothing Very Little General Knowledge Well Versed Experts Would you require marketing/training support? YESNO Would you need 24/7 technical support? YESNO Would you need simulation services? YESNO Please provide us with a simple first year proposal covering a. Go to Market strategies b. Growth prospects c. Sales/Mgmt Team d. Other new opportunities that you wish to pursue (we get a lot of ideas from our distributors and have begin exploring some ideas together)