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 an authorized distributor having been in business for twelve or more of the proceeding consecutive months, engaged in the inventory and distribution of flexible hose products, couplings, clamps, accessories or industrial rubber products (“Hose Products”).
2. Distributor must be authorized to distribute hose and fitting products that are manufactured by three or more suppliers, not to include companies or individuals who represent manufacturers as sales agents or stocking representatives, commonly referred to as manufacturers' representatives or agents.
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. Maintain, and annually provide evidence of, 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 ($995) once the application is approved.
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