Supplier Enrollment Application

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.*
Contact Information
*Company Name:
*Contact Name:
*Title:
Street Address:
City:
State:
Zip:
*Phone Number:
*Email Address:
Website Address:

Company Profile Information
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?

Marketshare Information
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?

Marketing Information
Does your company offer Marketing Dollar Funds (MDF) or Co-op funds?	Yes No
If yes, what are your company's MDF reimbursement requirements?