Distributor details

Apply to be an Authorized Gripad Dealer by thoroughly and accurately completing the secure online application form below. Your application will be reviewed for approval within 1 business day. You will be notified by e-mail that you're approved. A catalog will be sent out after approval.

GENERAL INFORMATION

Legal Name Email ID * Address BillingShipping		Business Name

City
State Zip / Postal Code Country		Other State
Phone		Fax
Website ( include http:// ) How did you hear about gripad? Personal Experience Magazine Word of mouth Internet Other
Have you personally used the Gripad brand in the past? Yes No

BUSINESS INFORMATION

Entity Structure
Corp LLC Partnership Individual

		Number of years in business
		Number of years at current location
		Number of locations
		Square footage

SALES CHANNEL

Gym or health club             Specialty Fitness

Sporting Goods                 Rehabilitation Centre     Personal Trainer

Export / International        Catalog     Internet

EXPLANATION / HISTORY OF BUSINESS

CONTACT INFORMATION

Owner / President
Phone		Email
Purchasing Contact
Phone		Email

Send me Gripad Newsletter

			Email Newsletter
© 2004-2013 GRIPAD Registered Trademark # 3198819 at USPTO and # 1114204 at WIPO Design Patents: #1314934-0001, #10649/2012, #38565, #201230033771.2

GRIPAD ® Distributor

Distributor details