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New Vendor Questionnaire
Please enter your mailing information below.
REQUIRED INFORMATION
*
CONTACT/COMPANY DETAILS
Company Name
*
First Name
*
Last Name
*
Address 1
*
Address 2
City
*
State/Province
*
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
U.S Military (AE)
U.S. Military (AA)
U.S. Military (AP)
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
--------------------------
AE - Armed Forces Africa
AA - Armed Forces Americas (except Canada)
AE - Armed Forces Canada
AE - Armed Forces Europe
AE - Armed Forces Middle East
AP - Armed Forces Pacific
Zip Code
*
Phone
*
Fax
Email
*
Web Adress
PRODUCT DETAILS
Product Name
*
Product Description
*
Major Market Category
*
Massage
Chiropractic
Spa
Country of Origin?
*
Is availability seasonal?
*
Are you willing to carry a guarantee or warranty?
*
Are instructions, directions, or assembly specs provided with product?
*
YES
NO
PRICING
Do you have Professional Pricing?
*
YES
NO
Suggested Retail Price to Public?
*
Do you sell direct?
*
YES
NO
Will you agree to holding prices for a full calendar year?
*
YES
NO
MARKETING RIGHTS
Do you currently have the rights to market this product?
*
YES
NO
If not, who does?
Are you the Manufacturer?
*
YES
NO
Where are you advertising currently?
What other companies currently carry your product?
Your estimated annual sales thus far?
*
Do you have a Minimum Advertised Pricing Policy
*
YES
NO
Do you have product images?
*
YES
NO
Would you be able to provide product for our own photography needs?
*
YES
NO
DEVELOPMENT STAGE
What stage of Development is this product currently in?
*
Conceptual
Production
Distribution
Comments on developmental stages:
Lead time from date of initial order?
TRADEMARK / COPYRIGHT
Is there a trademark or copyright on this product?
YES
NO
Will you consider an exclusive agreement with Scrip Companies?
YES
NO
SAMPLES
• If Scrip Companies is interested in your product for further review, will there be a charge for the samples you send? Please note: Products submitted to Scrip Companies will not be returned unless specified in writing. All products returned to Vendor will be at Vendor Cost.
*
YES
NO
• Do you provide free samples for potential customers "where applicable"?
*
YES
NO
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