STAFDA Membership Application

Independent Rep Membership Application

Manufacturer Membership Application

Distributor Membership Application

Membership Type

Acknowledgement

At least 50% of our sales are through independent distributors
STAFDA members will plan an important role in our marketing program.

At least 50% of our sales are to distributors serving the construction/industrial markets.
We represent a minimum of three STAFDA Manufacturer members (listed below).

More than 50% of our sales volume is done in power tools, fastening systems, and other construction/industrial products.
We wholly own (not consign) and maintain an inventory in these products of $50,000 or more.
We employ two or more outside sales people.

We comply with the above membership qualifications.(Required)

I certify the above qualifications are met by my organization.

STAFDA Member 1(Required)

STAFDA Member 2(Required)

STAFDA Member 3(Required)

Company Name(Required)

Company mailing address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Company physical address(Required)

Same as previous

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Toll Free

Fax

Email(Required)

Website

Your company contact(Required)

First Last

Title

Nature of operations(Required)

Stocking

Non-stocking

Branch Locations

Major Brands Sold(Required)

Description of product line(Required)

Business subjects of special interest

Year business was founded(Required)

Total Number of Employees(Required)

Total Number of Sales People(Required)

Number of direct sales people(Required)

We are GSA Certified(Required)

Yes

We are ISO Approved(Required)

Yes

Rental House?(Required)

Yes

Number of Manufacturer's Agents(Required)

Percent of total sales volume done by construction/industrial distributors (est.)(Required)

STAFDA houses comprise what percent of your total sales volume?(Required)

Annual Sales Volume(Required)

Number of factory owned distributor/warehouse service facilities you operate(Required)

Our territory covers (list of states)(Required)

Our STAFDA Contact is also responsible for Canadian sales(Required)

Yes

Name of partners, owners & officers(Required)

Annual Sales Volume(Required)

Major competitors(Required)

National trade associations and/or conventions/shows that you participate in

How did you hear of STAFDA?(Required)

Rank your top 5 choices for convention sites

Choice 1

Choice 2

Choice 3

Choice 4

Choice 5

Payment

STAFDA Annual Membership

Price:

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

CVC Code Name on Card

Name

This field is for validation purposes and should be left unchanged.