Thank you for your interest in MoreDirect. In order for your company to be evaluated for marketing opportunities within MoreDirect, please completely fill out and submit this form. Please understand due to limited internal resources to accommodate the demand, we will evaluate and contact you back as quickly as we can.

PLEASE NOTE: All fields preceded by an asterisk (*) are required.

*Company Name:

*Contact Name:

*Title:

Street Address:

City:

State:

Zip:

*Phone Number:

*Email Address:

Website Address:

Are you a manufacturer/distributor?
Manufacturer     Distributor

Please describe your company's product line:

Does any portion of your product line require authorization?
Yes     No

If yes, briefly describe the authorization process.

If manufacturer, is your product line available through the following distributors? (Select Multiple Distributors by holding down the control key.)

Ingram Micro
Synnex
Tech Data

Please list other distributors:

If your product line is not available through any of the above distributors, please list where MoreDirect can source your product.

Does your company sell through other resellers?
Yes     No

If yes, please list authorized resellers:

Does your company have EDI capabilities?
Yes     No

If yes, what transaction sets?

What makes your product line unique?

What is your company's target market?

Please list any vertical markets:

Please list your top product competitors:

Is your company currently doing any business with MoreDirect?
Yes     No

If so, what are your annual sales?

Does your company offer Marketing Dollar Funds (MDF) or Co-op funds?
Yes     No

If yes, what are your company's MDF reimbursement requirements?