Dealer Profile

U.S Customer Profile, Distributor

Thank you for your interest in our products. We hope we will be your preferred vendor and are looking forward to a long term profitable relationship. In order to serve you better, please complete the customer profile with as much information as you can. We need this information in order to know where to ship your orders and generate invoices. Your information is for internal use only and will not be shared with anybody outside of our office except companies that are pertinent to our transactions such as for shipping, Pay Pal, credit card, or wire transfers.

We will not be able to process your orders without this information.

Company name:_______________________

Address:___________________________

APT/Suite:________, City:____________, State _______Zip_______.

Check if shipping address is the same: Yes____ NO____

Your name:____________________________________..

Your position with the company:_____________________

Phone:___________ Fax:____________..

How many people work in your organization?______________________________________________________________ ___________________________________________________________________________

What is the buyer’s name?___________________________________________

Your e-mail address:____________@_____________.com

Do you operate out of a residence___or warehouse___

Your website:.http://www______________________.

Where will you primarily sell our products: Online ___, Auction _____, Store _____.

How do you prefer to pay? PayPal____, Credit Card____, Wire Transfer____ other(specify):_______________________________

What products are you interested in? _______________________________________________________________________ _______________________________________________________________________ _________________________________________________

What quantities:….less than 10__, less than 50__, more__.

Thank you for completing the customer profile. Please email it back to mike@minigadgets.com or fax to 1-866-770-9662, 1-770-772-9662.

If you need immediate help please call 1-800-772-6801.

The vendor (Mini Gadgets Inc.) and the distributor __________________________, mutually agree that they will not divulge any of the information exchanged in order to facilitate the distributorship business to anyone. Such as price list, prices of products, product line, discounts, sales channels and vendors sources.

Please sign and date below:

Name:______________________Title:________________Date:___/____/______Signature:_____________________