Become A Distributor

Become A Distributor
To become a distributor, complete and submit this form.

Contact Name:
Company Name:
Mailing Address:
City:
State, Zip:	,
Phone Number:	- -
Email Address:
How long have you been in business?
What types of products and/or services do you offer?
Do you sell retail, wholesale, online, other?	Retail Wholesale Online
Do you sell retail, wholesale, online, other?	other
How many retail locations do you support? (answer if applicable)
Are you currently a Locus distributor or dealer?	Yes No
Which Locus products are you primarily interested in selling? (Choose only one)	LOPEDS: POS PIN Distribution System Prepaid Long Distance Calling Cards Long Distance from Home Prepaid Wireless Services - Cards & Phones Prepaid VoIP Phone Service
Which additional products are you interested in selling? (Choose all that apply)	LOPEDS: POS PIN Distribution System Prepaid Long Distance Calling Cards Long Distance from Home Prepaid Wireless Services - Cards & Phones Prepaid VoIP Phone Service All
What non-Locus services (e.g. Cingular) are you interested in selling through LOPEDS?
Additional Comments
Best time to reach you:	Morning Afternoon Both