Interested in joining Alpine's dealer network?

Your Name:*

Your Title:

Your Company:*

Your Address:*

Your Street Address:

Your Address Line 2:

Your City:

Your State/Province/Region:

Your Postal/Zip Code:

Your Country:

Your Phone Number:*

Your Fax Number:*

Your Email Address:*

Your Website URL:

Do you have branch locations?
 Yes No

What Countries/Regions/Territory does your company serve?

SURVEY (For Apline's internal use only. Information provided below this point is strictly confidential.)

Do you have a Showroom?
 Yes No

How many years have you been in business?
 0-1 Years 1-5 Years 5-10 Years 10-15 Years 15 + Years

Does your company advertise commercial door products?
 Yes No

How many employees do you have currently?
 0-10 11-20 21-30 31-49 50+

How many installers do you currently employ?
 1 2-3 4-5 6-10 11-15 16-20 21+

How many service/installation vehicles do you currently utilize?
 1 2-3 4-5 6-10 11-15 16-20 20+

Do you provide 24 hour emergency repairs?
 Yes No

Do you have an emergency number, (Please Provide)?

Are your service/install vehicles equipped with welding machines?
 Yes No

If so, how many?

Are you a Union company?
 Yes No

If not, can you provide union labor?
 Yes No

What percentages (%) of all installtion work are (A + B =100%)

% Residential vs.

% Commercial

How many standard size (10' x 10') commercial doors can you install in a single day?

What is the maximum single contract dollar value your company will accept?

What is the company's year sales volume gross? ($)

Would you like to open a credit account with Alpine Overhead Doors?
 Yes No

If yes, what is the credit limit you would like to apply for? ($)

Does your company accept credit cards?
 Yes No

If yes, which ones do you accept
 Master Card Visa American Express Other(s)

If you checked others, please list all

Do you apply a surcharge for making payments via credit card?
 Yes No

If yes, please provide the amount or percentage (%):

Are you currently a dealer for any other overhead door manufacturers?
 Yes No

If yes, Who?

Would you be willing to sign a dealer network agreement?
 Yes No