MAD • MAYKER | Jesmonite USA DISTRIBUTOR Application
Distributor applications to sell MAD • MAYKER x Jesmonite products in the United States.
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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 zip 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 USA? *
Required
WHICH STATE(S) 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 states you have physical stores in. Scroll right and select all that apply.
Alabama
Alaska
Arizona
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
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 US 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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