Global Dealer Application

Your Name and title:

Business Name:

DBA:

Date Established Federal Employer No.

Phone No. Fax No.

E-Mail Address:

Physical Address (Street, Suite No.):

City State Zip Code:

Annual Sales Volume: $

Business Form:

Corporation LLC Limited Partnership

General Partnership Sole Ownership

Subsidiary of Division of

Parent Company:

Address:

Names and Address of Officers and/or Owners:

President:

Email address

Vice-President:

Email address

List any branch Offices

List any licenses, certifications or special training:

What is your Service Area? (We are trying to limit overlap between Authorized Dealers, so please be specific, give a mile radius around your home office along with various states/cities etc you service.)

Please tell us about your experience:

How long has your company been servicing Self Storage?

How many technicians or installers do you employ on a regular basis?

Customer References:

Please provide your information on the three most recent installation or repair jobs.

Customer City State Equipment/Job type No of units

Does your company have a specialty?

If yes, what is it?

Product Information:

Do you wish to receive advanced notice of upcoming products or

product enhancements? Yes No

What is your preferred method of contact? Phone Fax Email

Do you have any product enhancement suggestions?

If yes, please explain.

Are there any products that you would like to be made available?

If yes, please explain.

Which brands of access control and alarm equipment do you install?

What kind of equipment is it?

Which of these do you provide, install or service:

Perimiter Beam Installation

Perimiter Beam Service

Video Surveillance Systems

Access Control Installations

Access Control Service

Alarm System - Commercial

Alarm System - Mux or Single Unit

Install or Service CCTV

Install or Service Gate Operators

Install or Service Gates - Lift

Install or Service Gates - Slide

Install or Service Loop Detectors

So that we may best direct business opportunities to you, please provide the following information.

What is your current Service/Installation Rate Per Hour?

What is your Warranty?

Please attach a copy of your:

Current Installation Contract
Warranty
Sales Brouchure

Dealer/Installer Application Questionaire.

1. No Data will be shared with any competitor

2. Submission of Applicaiton does not guaranty acceptance by Global as an Authorized Dealer/Installer

3. This is an application to become an Authorized Dealer/Installer of Global Electronics' equipment. Credit terms subject to additional applications and approval by Global.

You may also download a PDF of this application by Clicking HERE.

When completed please fax toFx. 800-583-3062 or email to Sales@global-electronics.com