Become A Listed Dealer

Company Name

*

First Name

Last Name

Address Line 1

*

Address Line 2

City

*

State

*

Zip Code

*

Phone Number

Cell Phone Number

Fax Number

Email Address

Website URL

Dealer Questionaire
Primary Distributor	*
Secondary Distributor
Type of Dealer	Plumbing & Heating * Mechanical Contractor HVAC Dealer Fuel Oil Dealer Other
Customer Base	Residential * Commercial Institutional
Number of Employees	1-4 * 5-10 11-20 21-50 51-100 Over 100
Services	Installation * Service/Replacement Replacement Other

Dealer Questionaire

How many boilers do you typically install annually?
Have you or your staff attended factory technical training?	*