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Contact at Company

Contact Name:*

First Last

Title/Position at Company:*

Direct Phone Number or Extension:*

Email Address:*

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Description of Company (what do you do?)*

What product lines are you interested in? Please check all that apply.*

Product Line interest

Why are you interested in distributing Swivellink®*

Also, please let us know if you sell complementary products that will work with Swivellink®

Camera/Light/Sensor Mounting Solutions – Annual average of vision products sold

Stronguard – Annual quoting opportunities

Robot Pedestals – Annual average of robots sold

Conveyors – Annual quoting opportunities

Do you have the authority to set up this account?*

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If no, please provide: name, phone, email of person who has the authority to set up this account.