Dealer Application for Solar Water Heaters

Please Fill out this form completely to better help our Dealer Developmnent Team process your application through our system. Due to heavy interest in the SunMaxx Dealer Network, it may take our representative 1 - 2 business days to contact you. Please be patient.

*Application Type:

Dealer and Installer

Installer Only

General Information:

*First Name:

*Last Name:

*Company Name (DBA):

*Tax ID Number:

*Address 1:

*Address 2:

*City:

*State:

*Country:

*Zip Code:

*Phone Number:

*Fax Number:

*Email Address:

Website:

Specific Business Informaton:

*Primary Business Focus:

*Number of Years in Business:

*Have you ever installed Solar Hot Water Collectors or Systems before?

Yes

*If yes, what type of Solar Collectors have you used in your installations?

Evacuated Tube Collectors

Flat Plate Collectors

Both

*If yes, please indicate the quantity of each type of Solar Hot Water System you have installed:

*Number of Domestic Solar Hot Water

*Number of Radiant/Space Heating/Cooling

*Number of Pool & Spa Heating

*If yes, how many years have you been installing Solar Hot Water Systems?

*If yes, what percentage of your current workload does Solar Hot Water account for?

*In what area(s) are you looking to provide sales, installation and service? If you are covering a state, or more, please list the states - if you are covering less than a state, please list the zip codes, or counties that you are looking to cover.

Please indicate your first year expected sales goals broken down by quater:

*Q1	*Q2	*Q3	*Q4

Customer & Trade References:

Please List 3 Customers that you have provided plumbing, heating or other installation services in the last 3 years?

Customer 1:

*Name:

*Phone:

*System/Install Type:

Customer 2:

*Name:

*Phone:

*System/Install Type:

Customer 3:

*Name:

*Phone:

*System/Install Type:

Please list 3 current (or recent) trade references that you do business with. Can be a plumbing supplier, hardware supplier, banking/finance provider, etc.

Trade Reference 1:

*Company Name:

*Contact Person:

*Phone Number:

Trade Reference 2:

*Company Name:

*Contact Person:

*Phone Number:

Trade Reference 3:

*Company Name:

*Contact Person:

*Phone Number: