Handi Quilter

Manufacturer Representative Application

Date:
Name of Business:
DBA (if any):
Contact:
Title:
Address 1:
Address 2:
City:
State:
Zip:
Phone: (###)###-####
Fax: (###)###-####
E-mail:
Website:
Shipping address if different:
Address 1:
Address 2:
City:
State:
Zip:
Business Entity:
Corp
Partnership
Sole Proprietor
LLC
Other:

Federal Employee Identification Number:
Officer/Owner of Business: Title:
Officer/Owner of Business: Title:

If multiple store locations, indicate in which you intend to sell our products:


Description of current business:


Please include a picture of the store front:


Sewing Machine Brand Affiliation(s):


Retail Space of Business (Square footage):
Growth % Over the Past Three Years:

Annual Revenues:
Below $100,000
$100,000 - $250,000
$250,000 - $500,000
$500,000 - $1 million
$1 million +

Zoning of Business Location:
Commercial
Industrial
Residential
Other:

Number of Full-Time Employees:
Number of Part-Time Employees:
Square footage available for our products:
Number of classrooms for instruction:
Machine Quilting Instructors on staff? Yes No

If yes, describe experience and training:


Size/description of classroom:


Repair techinician on staff? Yes No
Years of technician experience:
Is your tech full time? Yes No

If part time, describe schedule:

Describe your tech's experience and the types of machines with which they have experience:

Other machine quilting products/frames you sell:


Indicate which Handi Quilter™ products you are interested in carrying:
HQ18 Avante™
HQ24 Fusion™
HQ Sweet Sixteen
HQ Pro-Stitcher
HQ Gadgets

Major surrounding cities:
Estimated Population (your city/market area):

Your philosophy of business - what makes you successful:

Describe why you would be our best choice for marketing our products in your area:

Quilt/trade shows in your area you would like to attend:


Humanness Check: