Independent MD Dealership Interest Form

* We have been in the central vacuum business since:

* We offer the following types of installations: (Check all that apply)
We do not offer installation
New Home Construction
Existing Home Construction
We install for other dealers as well

* We normally stock central vacuum inventory:
Yes
No

* We currently sell the following brands: (Check all that apply)
Beam/Electrolux
Nutone
Air Vac
Cyclovac
Canavac
Hayden
HP Vacuflo
Dirt Devil/Royal
Vacumaid
Dust Care
PowerStar
Eureka
Other (please specify)

* We service the following:
Only the brands we sell
All brands of central vacuums
We do not service central vacuums

* Our company advertises central vacuums:
Never
Minimally (2-3 times per year)
Average (4-6 times per year)
Frequently (at least every month)

Regarding Business:

Have you ever been involved in sales? Yes No
Have you ever operated a business? Yes No

Do you currently hold any contractor licenses? Yes No
Have you ever been in any construction trade? Yes No

What trades are you currently involved in (if any)?


What type of products are you currently selling (if any)?

* Have you ever installed central vacuums? Yes No

Would you feel comfortable with the installation aspects of central vacuums?
Yes No

What product volume do you anticipate for the areas?