Distributor Application Current

All applications are reviewed by NAHAD’s Membership Committee, which reserves the right to accept or reject any application for any reason.
Please complete all information below:
Company Name:
Company Phone:
Company Fax:
Web Address:
Company Email:
Contact Name:
Contact Title:
Contact Email:
Contact Phone:
How did you learn about NAHAD?
Number of Employees (Full Time Equivalent):
Products Distributed:
Year Company Founded:
DISTRIBUTOR MEMBER QUALIFICATIONS - Each box must be checked and/or completed:
1. Applicant must be a distributor engaged in the inventory and distribution of flexible hose products, couplings, clamps, accessories and/or industrial rubber products (“Hose Products”).
Membership requires three or more direct business relationships with NAHAD Manufacturing members. Please provide the names of three current suppliers of Hose Products:
A. Company Name:
A. Website:
A. Contact Name:
A. Contact Phone:
A. Contact Email:
A. Products Supplied:
B. Company Name:
B. Website:
B. Contact Name:
B. Contact Phone:
B. Contact Email:
B. Products Supplied:
C. Company Name:
C. Website:
C. Contact Name:
C. Contact Phone:
C. Contact Email:
C. Products Supplied:
3. Maintain, on average, at least US$50,000 worth of Hose Products in inventory
4. Have annual sales of at least US$250,000 of Hose Products
5. US and Canadian based companies must maintain Product Liability Insurance of at least US$500,000 - Insurance Company Name: Policy #:
6. Comply in full with NAHAD's Code of Business Conduct
Applicant agrees to comply with NAHAD Bylaws, rules and regulations and must certify that they meet the membership eligibility requirements by providing documentation to that effect if requested by the membership committee.
Upon receipt, applications will be reviewed by the NAHAD Membership Committee within 5-10 business days. You will be notified if your application has been approved or denied. By submitting this application you are agreeing to pay the required membership fee ($1250) once the application is approved.
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