AIA

Vendor Information Submittal Form
Note: Mandatory fields are marked with an asterisk ( * ).

Legal Business Name: *
Business Street Address: *
City: *
State/Province: *
ZIP/Postal Code: *

Business Contact Information

First Name: *
Last Name : *
E-Mail: *

Phone Number: *
Cellular Number:
Fax Number:
Years in Operation:
Dunn & Bradstreet #:
Current Market Coverage:

List 3 distributors you are currently providing services to:
Company Name
Contact
Phone Number

What product line(s) is your company known for within the promotional products industry?
 

Does your company operate outside of the promotional products industry?

Describe the product(s) and service provided and why you feel Adventures in Advertising should consider you as a preferred supplier.