Become a Distributor Please complete and submit the following online distributor application. You will be notified within 5-7 business days if you qualify for a PremumConwin distributorship. Distributor Application Company Date Shipping address Billing address Country Phone Website Executive contact Executive contact Email Sales contact Sales Contact email Marketing contact Marketing Contact email Accounting contact Accounting Contact email What is your primary business? Do you currently carry PremiumConwin equipment? Yes No Are you currently stocking balloon inflation equipment and related supplies? Yes No Do you have a walk-in storefront where PremiumConwin equipment will be displayed? Yes No Are you interested in distributing PremiumConwin's full product line? Yes No Where did you learn about PremiumConwin's products? Will your website feature PremiumConwin products? Yes No Do you have more than one distribution center? Yes No Which best describes your type of business? Wholesale Distributor Only Retail Sales Only Manufacturer/Distributor Wholesale & Retail What are your estimated annual purchases of PremiumConwin products? Less than $2,500 USD $2,500 – $5,000 USD $5,000 - $10,000 USD $10,000 - $20,000 USD $20,000 – $30,000 USD Over $30,000 USD SUBMIT