We are a

Dealer/Contractor : We are a plumbing dealer or contractor who purchases product from a distributor.

Distributor : We're a distributor who distributes product to plumbing dealers or contractors.

GENERAL INFORMATION

WHO IS YOUR DISTRIBUTOR/SUPPLIER?

YOUR COMPANY NAME

We have a different public company name.

YOUR COMPANY NAME

DEALER/CONTRACTOR INFORMATION

COMPANY NAME

They have a different public company name

STREET ADDRESS

ZIPCODE

CITY

COUNTRY

STATE/PROVINCE

PHONE NUMBER

WEBSITE

BUSINESS INFORMATION

PRODUCTS THAT YOU SELL

Water Heaters	Water Softeners	Water Filtration
Disposers	Ducted HVAC	Ductless HVAC
Commercial AC

DO YOU PRIMARILY SELL HVAC UNITS ?

If you primarily sell HVAC units, we recommend signing up for our HVAC Partner Program instead.

CURRENT APPLICATION FOCUS

Residential Replacement	Residential New Construction
Commercial Applications

ZIP CODES THAT YOU SERVE(COMMA SEPARATED)

Central service area zipcode

radius you serve from this central zipcode(miles)

WHAT IS YOUR ANNUAL PLUMBING SALES REVENUE?

Under $50,000	$51,000 - $100,000
$101,000 - $150,000	$150,000 Plus

ABOUT HOW MUCH OF YOUR BUSINESS IS WITH GE(%)?

HOW MANY EMPLOYEES DO YOU HAVE?

1 - 20 Employees	21 - 50 Employees
51 - 100 Employees	100+ Employees

PLEASE SELECT ALL BRANDS THAT YOU SELL

GE Appliances	A.O. Smith	Bradford White
Rheem	Whirlpool	Other

OTHER BRANDS CURRENTLY SELLING

PROGRAM ACCOUNTS

PRIMARY ADMIN ACCOUNT

FIRST NAME

LAST NAME

JOB TITLE

EMAIL ADDRESS

PHONE NUMBER

TERMS AND CONDITIONS

I agree to the terms and conditions.

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