Bucks Switch-N-Go - Distributor Application

Welcome From The Support Team At Switch-N-Go

If you are interested in becoming a Switch-N-Go Distributor, completing the following form is the first step in making that happen. Once we receive your completed forms, we will receive your information via email and we will begin the application process. If you have any questions as you work your way through the application process, do not hesitate to contact the factory directly. Thank you for your interest in Switch-N-Go™, we look forward to working with you in the near future.

Company Name	*
Contact Name	*
Contact Title
Address	*
City, State	*
Zip	*
Country
Work Phone	*
Home Phone
Mobile
Fax
E-mail	*
Web Site
Years in Business
I am interested in Switch-N-Go for the following reason:	*

Rate Your Company's Skill (5-Best)		Marketing Will Include
Sales		Site Calls
Entrepreneurship		Direct Mail
Operations		Retail Storefronts
Purchasing Facilities		Product Demos
Marketing		Billboard
Administrative		Print Ads
Installation		Trade Shows

My Current Career*	*
My Current Product Lines:
Office Square Feet			Warehouse Square Feet
I can sell and service the following territory* (list boundary or radius)	*
I will make the following initial order*	*
I project to sell the following volume in the first year*	*
Additional info you would like



Check that the fields with an asterisk (*) are completed as they are required. Then click submit below. By clicking the submit button below, you agree to the Confidentiality Agreement shown in the right column.

Confidentiality Agreement:

The information to be shared between Deist Industries, Inc. and you is confidential. By clicking this box and submitting this request, you agree that any such disclosure is made only upon the following terms and conditions:
All such disclosures (whether oral, written or otherwise) made by Deist Industries, Inc. are deemed to be confidential and secret. Deist Industries, Inc.'s file memoranda or notes, whether made during or after conversations, shall be conclusive evidence of the information disclosed to you and its confidentiality. All Proprietary Information disclosed to you is for your evaluation purposes only. You agree not to make, directly or indirectly, any commercial or other use of such Proprietary Information without Deist Industries, Inc.'s prior, express, written permission. You agree to take such precautions as may be necessary to prevent the disclosure of any such Proprietary Information to others.

You recognize that Deist Industries, Inc. owns all of the rights with respect to all of the Proprietary Information disclosed to you. No right, express or implied, is conveyed to you by the disclosures made by Deist Industries, Inc. to you. You agree not to make any copies of any of the Proprietary Information without Deist Industries, Inc.'s prior, express, written permission.

[ Welcome ] [ Distributor Application Confirmation ]

Click HERE for FINANCING OPTIONS - Harbour Capital Corporation in conjunction with Switch-N-Go