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Distributor Application

SJE Rhombus is a manufacturer who sells to authorized distributors who have supplied a resale certificate. If you would like to be qualified as an authorized distributor, please complete the application form listed below and forward a resale certificate to SJE Rhombus. A SJE Rhombus Customer Service Representative will process this application and contact you regarding volume pricing discounts available. If you would rather fax this form to us please print, complete and fax it to 218-847-4617. We look forward to working with you!

This form must be completed in English.

Your Company's Name*
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Order Acknowledgement Email*
Invoice Email
Phone
Fax
President/Owner
Company ID
Number of Years in Business
Number of Employees
Are you a reseller?
- Yes
- No
Type of Business
Anticipated annual sales volume (in US Dollars) of floats, alarms & panels:
What industries do you currently supply?
Who do you currently sell to?
What products do you currently distribute?
Type of credit requesting:
Estimated monthly credit:
Applying for a credit card account? Please skip to "Ship to Address".

Fill out this section only if the type of credit you are requesting is an Open Account or Prepayment
Please provide bank references:
Full Bank Name
Account Number
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Email
Please provide trade references: (All three reference must be entered to complete this application)
Reference #1
Company Name
Contact Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Email
Reference #2
Company Name
Company Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Email
Reference #3
Contact Name
Company Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Fax
Email
Ship to Address
(for products that need to be shipped to a location different than the billing address provided above)
Name/Attn To
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Comments:
CAPTCHA

Distributor Application

Applying for a credit card account? Please skip to "Ship to Address".

Please provide trade references: (All three reference must be entered to complete this application)

Reference #1

Reference #2

Reference #3

Ship to Address