Elevation

Please fill out the entire form below form below or contact us directly to arrange a more detailed screening.

Last Name *

First Name *

Street Address

City/Province/Region *

State *

Country *

Cell Phone

Phone *

Email *

Education

Describe the geographic region you cover *

What was your approximate sales volume for the previous year?

What is your forecast for the current year

Experience

Years of Sales Experience *

Years as an Independent Rep *

General Focus of the Lines you Rep (ex. Medical, Retail, Computer Hardware) *

Current Lines you Rep with brief description *

Past Lines you have represented *

What are you financial expectations in a new line *

Do you work solo or or are you part of a rep group? If in a group, how many reps do you have? *

Can you name your major accounts

Are you able to generate proposals? * yesno

What is your website?

Do you have warehouse capability? * yesno

Are you interested in representing services? * yesno

Do you attend trade shows? * yesno

Please include any other information you feel will be valuable in matching you with a client. Resume, references, recommendations, referrals, etc...