Becoming a Distributor Full Name Business Name Email Address Phone Number Address Type of Business RetailerWholesalerOnline StoreOther Years in Business Current Products Sold Annual Revenue (optional) Target Market Geographical Coverage Competitor Products Carried Preferred Payment Terms Net 30Net 60 Warehouse/Storage Capacity Why do you want to become a distributor for EOTAPS? How do you plan to market and distribute our products? Any special requests or additional information Agreement By submitting this application, I certify that the information provided is true and accurate to the best of my knowledge and agree to adhere to the terms and conditions set forth by OETAPS for its distributors. I agree