Distributor / Representative Application


The following is our Distributor / Representative application for the DocMagnet product line. If you wish to be considered for distribution or representation rights please fill out the application and we will contact you as soon as possible.

Company Name*
Email Address*
Contact Person*

Please leave this field empty.

Phone Number*
Fax Number
Number of Sales People*
Number of Offices/Locations*
Territories Covered*
Type of Organization
 Distributor Rep Group Independent Rep
Stocking Distributor
 Yes No
DocMagnet Product Interest
 Permanent Lifting Magnets Battery Operated Lifting Magnets Heavy Lifting Magnets Milling Magnets Milling Magnet Modules Magnetic Lathe Chucks Quick Mold Change or Die Change Magnets
Other Comments