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Manufacturer Representative Application
Home
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Rep Form
Handi Quilter
Manufacturer Representative Application
Date:
Name of Business:
DBA (if any):
Contact:
Title:
Address 1:
Address 2:
City:
State:
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Zip:
Phone: (###)###-####
Fax: (###)###-####
E-mail:
Website:
Shipping address if different:
Address 1:
Address 2:
City:
State:
None chosen
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Zip:
Business Entity:
Corp
Partnership
Sole Proprietor
LLC
Other:
Federal Employee Identification Number:
Officer/Owner of Business:
Title:
Officer/Owner of Business:
Title:
If multiple store locations, indicate in which you intend to sell our products:
Description of current business:
Please include a picture of the store front:
Sewing Machine Brand Affiliation(s):
Retail Space of Business (Square footage):
Growth % Over the Past Three Years:
Annual Revenues:
Below $100,000
$100,000 - $250,000
$250,000 - $500,000
$500,000 - $1 million
$1 million +
Zoning of Business Location:
Commercial
Industrial
Residential
Other:
Number of Full-Time Employees:
Number of Part-Time Employees:
Square footage available for our products:
Number of classrooms for instruction:
Machine Quilting Instructors on staff?
Yes
No
If yes, describe experience and training:
Size/description of classroom:
Repair techinician on staff?
Yes
No
Years of technician experience:
Is your tech full time?
Yes
No
If part time, describe schedule:
Describe your tech's experience and the types of machines with which they have experience:
Other machine quilting products/frames you sell:
Indicate which Handi Quilter™ products you are interesed in carrying:
HQ Sixteen Quilting Machine & Portable Professional Frame
HQ II Home Quilting Frame
Adjustable Length Table
QuilTable
HQ Studio Frame
Major surrounding cities:
Estimated Population (your city/market area):
Your philosophy of business - what makes you successful:
Describe why you would be our best choice for marketing our products in your area:
Quilt/trade shows in your area you would like to attend: