Become a Distributor

Please drop an e-mail or fill out the form below to be e-mailed the contact information for your local distributor.
Distributor Information
Distributor Name: *
Address: *
City: *
State/Province: *
Postcode: *
Country: *
Phone: *
Fax: *
Email: *
Company Website: *
Principal contact and title: *
Principal contact‘s email: *
Number of sales people: *
Purchasing contact: *
References
Please provide three trade references:
Distributor Services
Number of Years In Bussiness: *
Annual Revenue(Specify Currency): *
Territory: *
Please state how you plan to market and promote Additel Instruments:
  *
Please list the tradeshows your company attends each year:
  *
How many Additel instruments units do you expect to sell in the next 12 months?