MAD • MAYKER | Jesmonite CANADA DISTRIBUTOR Application
Distributor applications to sell MAD • MAYKER x Jesmonite products in Canada
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Email *
What is your company name? *
What is your company website? *
WHAT IS YOUR COMPANY FULL BUSINESS ADDRESS? *
If you have multiple business addresses, please list your main business address. Please provide the full address with postal code.
What is your first and last name? *
What is your role in the company? *
What is your phone number? *
How many PHYSICAL retail stores does your company have, if any? *
Do you have an e-commerce store that ships within THE CANADA? *
Required
WHICH PROVINCES/TERRITORIES DO YOU DISTRIBUTE/SELL FROM? *
EXAMPLE: Your warehouse(s), Distribution Centre(s), 3PLs, Retail Stores etc. in which you ship from. For retailers, you may select all provinces you have physical stores in. Scroll right and select all that apply.
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
State:
Which MAD • MAYKER x Jesmonite products are you interested in selling? (select all that apply) *
Required
Approximately, when are you looking to start selling Jesmonite products? *
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What is your anticipated FIRST ORDER volume? (in CANADIAN dollars) *
How does your company support customer inquiries / post-sales support? *
Required
Lastly, tell us a bit about your business and why you would like to become a DISTRIBUTOR of MAD • MAYKER x Jesmonite products? *
The more information here the better! We want to hear about your company, your customers, how you do business, and how MAD • MAYKER x Jesmonite products will help your customers. You may use paragraph responses in this field. 
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