Sper Scientific Ltd. Distributor/Rep Application Form

Domestic Distributor Terms
· Payment Terms are net 30
· First time order must equal a minimum of $500.00, after that there are no minimums
· FOB: Scottsdale, AZ

Sper Scientific Ltd. Distributor/Rep Application Form

Form can be submitted online if your default mail client is Outlook.

If not, please download form, fill-out, and send as attachment to sales@sperscientific.com

Company name:
Phone #:
Fax #:
Email:
Address:
President/General Manager:
Contact:
Annual Sales ($):
Number of sales people:		inside sales:
		outside sales:
Do you produce and distribute a catalog? If yes, please send us a copy		Yes No
Where do you distribute your products? (geographically)
City:	Country:
City:	Country:
City:	Country:
What markets do you cover?		Laboratory Education School Safety Other
What products do you import now?
Country:		Manufacturer:
Country:		Manufacturer:
Country:		Manufacturer:
What products do you plan to import?
Country:		Manufacturer:
Country:		Manufacturer:
Country:		Manufacturer:
Three Trade References:
1) Name & Address:		Phone: Fax:
2) Name & Address:		Phone: Fax:
3) Name & Address:		Phone: Fax:
Bank Address & Phone/Fax #:
Account #
Federal Tax #
Resale #
Shipping Methods (Fed Ex, UPS, Etc.):
Insurance Requirements:
Thank You

SPER SCIENTIFIC LTD. 7720 East Redfield Rd, #7 Scottsdale, AZ 85260
Phone: (480) 948-4448 | Fax: (480) 967-8736 | Email: info@sperscientific.com