Become An UltraTech Distributor

Thank you for your interest in distributing UltraTech products in your market.  We’re excited by the possibility of working together to create a long-term mutually profitable commercial relationship.

In order for us to understand how we might work together, please provide the following information about your company.  Please be aware that completing the form below does not ensure distribution rights will be granted. 

We promise to respect your privacy

First Name: *

Last Name: *

Company: *

Address: *

City: *

State/Province: *

Zip: *

Country: * AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic Republic of TheCook IslandsCosta RicaCote D’ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-bissauGuyanaHaitiHeard Island and Mcdonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Democratic People’s Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People’s Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, The Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian Territory, OccupiedPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and The GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and The South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-lesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe

Email: *

Website:

Phone: *

Fax:

How did you hear about us?: * - Select -Internet SearchEmailTrade ShowMagazine AdDirect MailingReferralBlogFacebookNot ProvidedOther

Other:

Primary sales territory: *

Do you stock product?: *

Yes

No

What products and brands do you currently sell?: *

Approximately how many active end users do you sell to?: * - Select -25-100100-250250-500500-10001000-25002500+

Approximately how many resellers do you sell to?: * - Select -1-55-1010-2525-5050-100100-250250+

Which industries do you distribute to?: * - Select -AgricultureAutomotiveChemicalCoatingsConcreteConstructionConsultantConsumer/DIYEnergyEngineeringEnvironmentalFire Dept / HazmatFurniture and Household GoodsGovernment – FederalGovernment – LocalIndustrial DistributionLogisticsManufacturing and DistributionMarine / ShippingMaterial HandlingMilitaryMiningOil & GasSafetyServiceSporting GoodsToolsTransportationUtilitiesWaste ManagementWater Treatment

Other Industry:

Annual Revenue ($USD): * - Select ---None--$ 0 - $100,000$100,000 - $500,000$500,000 - $1,000,000$ 1,000,000 - $5,000,000$5,000,000 - $10,000,000$10,000,000 - $25,000,000$25,000,000 - $100,000,000$100,000,000 - $500,000,000$500,000,000 +

How many employees do you have?: *

How many sales personnel?: *

How do you market?: * - Select -Direct SalesResellersInternetCatalog

How long have you been in business? (Yrs.): *

Have you ever sold competitive products?: *

Yes

No

If yes, which company(s)?:

If interested in distributing Ultra-Ever Dry:

Click here

Comments:

CAPTCHA

This question is for testing whether you are a human visitor and to prevent automated spam submissions.

What code is in the image?: *

Enter the characters shown in the image.