Prospective Distributor/Reseller Questionnaire

Thank you for visiting our web site and considering the exciting opportunity to become a Distributor/Reseller of Gemba Solutions OEE IMPACT Products and Services.

Hopefully you would have had a good look around our web site www.oeeimpact.com and understood our products and services prior to submitting this questionnaire. If you have any questions that you would like to be answered prior to filling out the questionnaire then please send an email to sales@gembasolutions.com or call our head office number (UK): +44 (0)2476 796615 and ask for sales.

To assist us in qualifying your request please complete this questionnaire as thoroughly as possible so full consideration can be given to your suitability. We intend to respond to any questionnaire within 5 working days

All information provided will be treated in the strictest confidence and will not be passed onto any third party.

YOUR COMPANY PROFILE:

Contact Name:
Company Name:
Address:
Telephone Number:
Fax Number:
Email Address:
Website Address:
Number of Employees:
Main offices/ Countries
Senior Executives: (Name, positions, and qualifications)
What is your present annual sales (indicate currency)?
Number of sales people:	Outside Inside
What region/countries do you presently cover?

COMPANY FOCUS: Please specify your Top 3 target industries or markets		Key Applications in that market:

1st	% of Total Annual Sales
2nd	% of Total Annual Sales
3rd	% of Total Annual Sales

PRIMARY PRODUCTS OF INTEREST: Check all that apply	ANTICIPATED SALES OF GEMBA PRODUCTS:

OEE IMPACT ME Software	after 1 year.
OEE IMPACT Connect Software and Hardware	after 2 years.
OEE IMPACT Engineering Services	after 3 years.
OEE IMPACT Training Services

OTHER INFORMATION:
What technical qualifications do your sales people have?
Please list all existing companies and products represented by your company:
Do you have your own in-house M.E.S. engineering team?	Yes No
Would you appoint a GEMBA SOLUTIONS specialist or product manager?	Yes No
Why should GEMBA SOLUTIONS select you as a distributor, and future business partner?
What Trade Shows do you currently participate in?
What would be your plans to advertise, exhibit, and/or promote the GEMBA Solutions Product Range and services?
Please list your bankers names and addresses and two other principle names from whom commercial references could be obtained.

This document does not constitute an agreement between the applicant and GEMBA SOLUTIONS as a representative of GEMBA SOLUTIONS LTD Products or Services.

OEE IMPACT's continuous improvement cycle

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