EASE PRODUCT RESELLER APPLICATION

Interested in becoming an EASE Product Reseller?
 Complete the application below and click the Submit button at the bottom.  
If you have any questions about the application, send us an email.
PRODUCT LINE
Select which product line(s) you are interested in reselling below.
Professional Diagnostic Product Line - Includes Professional PC Scan Tool, Wireless Vehicle Interfaces, Reprogramming Systems, PC Scope, EWINs and 4/5 Gas Analyzers
Vehicle Monitoring Product Line - Includes AutoWatch and AutoWatch for Fleets
SDK (Software Developer's Kit) and EASE Vehicle Interfaces
  
COMPANY/INDIVIDUAL INFORMATION

*indicates required field 

Company:

*Contact:

*Address 1:

Address 2:

*City:

*US State:

*ZIP:
(required for US & Canada only) 

*Country:

*Telephone:

Fax: 

Cell Phone:

*E-mail: 

Business Type:

Years in Business:

Web Site:

   
 
INTERVIEW QUESTIONS - Professional Product Line Only
If you are applying to be a Reseller for our Professional Diagnostics Product Line, please answer the questions below as completely as possible.  (Consumer Diagnostics and Vehicle Monitoring applicants can skip this section and proceed to the bottom of the form).

Are you currently employed in sales?

If Yes, what products do you currently sell?

Will you continue representing the products listed above while representing EASE products?

      
If a company, how many people would be representing EASE Products
If in multiple locations, please list.
     

Are you or your employees experienced in the Automotive Diagnostics Industry?

If Yes, please explain

      
Will your current customer base be interested in EASE products or will you be developing a new customer base?  Please explain.
Primary sales region(s) that you will be actively working.
Briefly, how would you sell our products?
   
Any additional information or comments you would like to add? (optional)
 
CUSTOMER REFERENCES 
list 3 customers that EASE can contact for references
Company:
Contact:
Phone :

Fax:
Address:
City:
State:

Zip:
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SUPPLIERS/VENDORS REFERENCES 
List 3 of your suppliers/vendors that EASE can contact for references
Company:
Contact:
Phone :

Fax:
Address:
City:
State:

Zip:
Company:
Contact:
Phone :

Fax:
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Company:
Contact:
Phone :

Fax:
Address:
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Zip:
 

             

Thank You for your Application,

EASE Diagnostics
National Sales Department

 

   Please click on the Submit button below.
You will be sent via e-mail a printable version of this document.