Dealership Enquiry Complete the form below, and a representative from RIPPL will get in touch with you within 24 hours. Company Name Year Established Legal Structure Position/Title Email Address Phone Number Street Address City State Country Postal Code Website URL Business Type Industry/Sector Focus Number of Employees Annual Revenue Current Product/Service Offerings List of current major suppliers Number of years of association with current suppliers Current range of products Current Payment Terms with your suppliers List of Current Key Customers Location/s (in case of multiple locations) Experience with Online Sales and E-Commerce Target Clients Residential Office Space Hotel & Hospitality Industry Retail Others Experience Selling Lighting Products Yes No If Yes, total years of experience in Lighting Sales Sales Channels Used Direct Online Architects/ Designers Electrical Contractors General Contractors What interests you about our Company/Products? Why would you like to work together? How will RIPPL Lighting fit into your Brand Vision? Are you willing to promote our products under the RIPPL Lighting brand? Yes No Type of Support Needed from Us Preferred Communication Methods and Frequency Availability for Training and Meetings Willingness to Participate in Co-Branding Initiatives Yes No Willingness to Provide Sales Forecasts and Market Feedback Yes No Business License Number Tax Identification Number Compliance with Local Regulations Yes No Any Pending Legal Issues Yes No If yes, please specify Business Reference 1 Company Position Contact Information Business Reference 2 Company Position Contact Information Date Print Name Position/Title in Company Submit