APPLICATION FOR NEW, NON-EXISTING ANCHOR DEALERS ONLY

New Dealer Application
Company Name:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:
 
Federal ID Number:
Resale Number:
   
  Principle Officer
First Name:
Last Name:
   
  Controller Officer
First Name:
Last Name:
   
  Sales Manager
First Name:
Last Name:
   
  Purchasing Manager
First Name:
Last Name:
   
  Service Manager
First Name:
Last Name:
   
  Service Technician
First Name:
Last Name:
   
   
  Number of Sales people in your office:
   
  Do sales people call on customers:
yes No
   
  Who should receive our mailings and price lists:
   
  Do you lend equipment for trial?
Yes No
   
  Do you rent equipment?
Yes No
   
  Do you have a company advertizing program?
Yes No
   
   
  If yes, please describe:
   
  Do you have direct mail programs?
Yes No
   
  If yes, please describe:

   
  What can we provide you in sales efforts:
   
  What other lines do you carry:
   
  Please desribe your client market profile based on following choices (choose all that apply)
   
  Education:
Yes No
   
  Federal Government:
yes No
   
  Institional:
Yes No
   
  Commercial:
Yes No
   
  State Government:
Yes No
   
  Industrial:
Yes No
   
  Local Government:
Yes No
   
  Other:
 
Anchor Audio, Inc. • 3415 Lomita Blvd. • Torrance CA • 90505 • (800) 262-4671 • Fax: (310) 784-0066