Become a Sechrist Industries, Inc. business sales partner. Sechrist Industries is an established manufacturer of quality medical products and has a market share in over 100 countries world wide for over 30 years. Please take a moment to fill out the information below to apply to become a business partner.

 Please provide the following product information:

Company
Years in Business
Number of Employees
First Name
Last Name
Title
Email Address
Website Address
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX

 Company Specifics

How would you describe your company?
Manufacturer	Independent	Reseller

Which type of customer do you generate business from?
End User	Dealers	Government	Other

What were your annual sales in 2008? (USD)

less then $100,000 $100,000 to $500,000 $500,000 to $1,000,000 $1,000,000 to $5,000,000 greater then $5,000,000

How many sales people within your company? (total inside and outside)

How many locations does your company have?

What products does you company currently represent?
Home Vents	ICU Vents	Accessories	Other

Which type of products would you be interested in selling?
Ventilators	Hyperbaric Chambers	Air/Oxygen Mixers

What type of ventilation products does you company sell?
Covidien	Carefusion	Maquet
Resmed/Saime	Respironics	Hamilton
Drager	Seporated by comm

 

What other companies do you represent?

 

What trade shows have you recently attended as an exhibitor?

 

What publications do you advertise?

 

Do you have a demo area at you main facility?

Yes    No

Are you willing to buy a demo unit for your demo area?

Yes    No