Thermax World Headquarters Online - Cleaning Nature's way, with water.

"I not only wanted it, I needed it...My carpet doesn't look like the same carpet since I've been using my [Thermax]"
- Mary Ann's Flower Emporium

"Our son's allergies have gotten better...We would recommend this to anyone who suffers from allergies or has small children."
- Diane Madison

DV12 & CP5 Distributor Application

Company Information

Fields with an * are required.

First Name*:

Last Name*:

Are you currently business owner?

Yes No

Do you have an active business license?

Yes No

Do you have an active Tax ID #?

Yes No

Company Name:

Address:

Suite / Apt. No.:

City:

State:

Zip Code:

Business Phone:

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Best # to reach you:

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Fax:

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E-mail Address*:

Website:

Business Hours:

Nature of Business Location:

Products your company currently sells:

You plan to distribute Thermax products:

Products and Services
Please specify products and services you will offer.
Thermax CP5 Commercial Carpet & Upholstery Steam Cleaner)
Will you market and sell the CP5?*:	Yes No
Will provide service for this product?*:	Yes No
How do you plan on marketing this particular product line?:

Who will you be approaching as your potential customers?:

Thermax DV12 Commercial Carpet & Upholstery Steam Cleaner
Will you market and sell the DV12?*:	Yes No
Will provide service for this product?*:	Yes No
How do you plan on marketing this particular product line?:

Who will you be approaching as your potential customers?:

Additional Information

Please list the zip code/s in which plan to market and/or want protection in:

How did you hear about Thermax*:

Comments:

Somone from our corporate office will contact you within 1 to 2 business days of you submitting this application.