For information on becoming a PremierDPH Vendor please fill out the form below so that a representative can contact you.
   
Firm Name:
Contact Name:
Address:
City:
State:
 ZIP:
Telephone:

FAX:
Email:

Please give us a breif description of your product(s):
What are your current annual sales in the U.S. and Canada? 
How many dealers/distributors do you currently sell to in the US and Canada?
Do you currently distribute nationally?

What is your method of distribution?
Do you currently, or are planning to, sell to the "big boxes"?

Are you currently selling to any PremierDPH members, and if so, which ones?

Are you currently a vendor of any other buying group, If so, which one(s)?

Tell us why you would like to become a PremierDPH Vendor, and provide any additional information about your company: