REPSOURCE MEMBERSHIP

RepSource .....At the speed of business

RepSource
Ad Placement

See a representative SAMPLE ADVERTISEMENT HERE.

Complete the online RepSource Questionnaire so we can create your
online advertisement on the RepSource Network:

NOTE: This questionnaire enables us to prepare your advertisement. Once you press the submit button (#7) at the bottom of this questionnaire, you will be forwarded to our server. Upon completion of your submission below, we will create your advertisement within 2-3 days.

1) Please provide the following contact information:

First Name

Last Name

Organization

Work Phone

FAX

E-mail

URL

2)   SEEKING REPS: Use the space below to tell RepSource REP/AGENCY members what the types of products you manufacture
       (service or hard goods) requiring representation. These may be physical or intellectual products.
       If the product category is not listed on our current list, we will create a new category.

3) SEEKING REPS: Use the space below to tell REP/AGENCY RepSource members what industry(ies) your products
(manufacture (service or hard goods) would be sold into. If the industry category is not listed on our current list, we will create a new category

4) SEEKING REPS: Use the space below to tell REP/AGENCY RepSource members in which State(s) (or Province) you require representation.
If more than one state or province, please let members know. If you require reps across the country, please indicate that information as well.

5) SEEKING REPS: Use the space below to tell REP/AGENCY RepSource members in which State(s) (or Province) you require representation.
If required in more than one state or province, please let members know. If you require reps across the country, please indicate that information
as well. Here is an example from previous members to assist you. (SAMPLE HERE)

6) Other pertinent information

Press the submit button below.

7)

First Name
Last Name
Organization
Work Phone
FAX
E-mail
URL