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2016 Mobile Distributor of the Year
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Questions marked with a
*
are required
Your Information
(We may contact you to follow up with additional questions on your nomination.)
Name:
Title:
Company:
Location (city, state):
Phone:
Email:
*
How do you know this distributor? (Select one)
(Required.)
I am a customer
I am a district manager
I am a competitor
I am a fellow flag distributor with a different route
Other (please specify)
Nominee's Information (The distributor you are nominating):
Name:
Company:
Location (city, state):
Phone:
Email:
Years in the Business:
*
Annual Revenue:
(Required.)
Under $50,000
$50,001-$100,000
$100,001-$250,000
$250,001-$500,000
$500,001- $1 million
$1 million or more
Unsure
*
Primary Territory Description:
(Required.)
Rural
City/Urban
Town/Suburban
*
Customer Base (check all that apply):
(Required.)
Automotive Service Stations
Heavy Duty or Fleet Repair Facilities
Aircraft Maintenance Facilities
Industrial / Manufacturing Facilities
Body Shops / Collision Repair
Marine Repair
ATV / Off-Road Service Centers
New / Used Automotive Dealerships
Farm / Agriculture
Educational Facilities / Tech Schools
Other (please specify)
