Prospective Distributor Questionaire

Please complete this questionaire as thoroughly as possible
so full consideration can be given to your suitability.

COMPANY PROFILE
Contact Name:
Company Name:
Address:
Telephone Number:
Fax Number:
Email Address:
Website Address:
Number of Employees:
Branch Offices/Warehouses:
Senior Executives: (Name, positions, and qualifications)
What is your present annual sales (U.S. Dollars)?:
Number of sales people:	Outside       Inside
What region/countries do you presently cover?

TOP 5 PRODUCT LINES AND PERCENTAGE OF TOTAL SALES:
1st		% of Total Annual Sales	Growing Declining Flat
2nd		% of Total Annual Sales	Growing Declining Flat
3rd		% of Total Annual Sales	Growing Declining Flat
4th		% of Total Annual Sales	Growing Declining Flat
5th		% of Total Annual Sales	Growing Declining Flat

COMPANY FOCUS: Please specify your Top 3 target industries or markets			Key Applications in that market:
1st		% of Total Annual Sales
2nd		% of Total Annual Sales
3rd		% of Total Annual Sales

PRIMARY PRODUCTS OF INTEREST: Check all that apply	ANTICIPATED SALES OF KEY SOLUTIONS PRODUCTS:
Airborne Particle Counters	after 1 year.
Liquid-Borne Particle Counters	after 2 years.
Conductivity/Resistivity Meters	after 3 years.
Airborne Samplers/Culture Media
Anemometers/MicroManometers
Temperature/Humidity Transmitters
O'Rings and Seals

OTHER:
What technical qualifications do your sales people have?
List of existing companies and products represented:
Do you have your own distribution transport?	Yes     No
Would you appoint a specialist or product manager?	Yes     No
Why should Key Solutions select you as a distributor, and future business partner?
What Trade Shows do you currently participate in?
What would be your plans to advertise, exhibit, and/or promote the complete  product line?
Please list your bankers names and addresses and two other principle names from whom commercial references could be obtained.
This document does not constitute an agreement between the applicant and Key Solutions Pte Ltd as a representative of our products.