Fugawi Software - Dealer Application

Do you own a retail store or web site which focuses on sales of any of the following?

Marine Electronics	GPS Receivers
Maps	Boats or boat accessories
Camping, Hiking or Hunting Supplies	Travel books

If the answer is yes, then there is certainly a Fugawi product which would be of interest to your customers.

Northport offers a generous dealer/reseller program. Stocking dealers, drop ship dealers, and web affiliate dealers are all supported with varying discount structures.

If your company is interested in reselling Fugawi products, please complete this form. Your application will be reviewed by one of our sales team within two business days.

( * Indicates Required Fields)

Part A: Your Details
Name:	*
Your Position or Title:
Phone:	*
Fax:
Email Address:	*
Website:
Your Company Name:	*
Trading Name (if different):
Street Address:	*
PO Box (if required):
City:	*
State/Province:	*
Zip/Postal:
Country:	*
Part B: About your Company
What is your business type? * (Please tick all that apply)	Retail Store Web Retailer Wholesale Distributor Other
What types of products do you currently sell? * (Please tick all that apply)	Maps Books GPS Receivers Computer Software Handheld Computers Marine Electronics Boat Accessories Camping Supplies Hunting Supplies Fishing Supplies Other
Do you currently sell software or digital maps?	*
What area/region/territory do you sell to most?	*
How many years has your company been in business? *	*
List the top three products which are currently sold by your company	1: 2: 3:
Part C: Interest In Our Products
Which of our products are you interested in selling? *	Fugawi Marine ENC Avia Instrument Software for Sail or Power Boats Fugawi Global Navigator Fugawi UK Digital Maps Actisense NMEA 0183 or NMEA 2000® products Other
How do you plan to market and display our products?
Anticipated Initial Order Size:
Additional Comments:

Your application is not automatically accepted. Northport Systems Inc. reserves the right to review and accept applications at its sole discretion.

Please submit only one application, we will respond to all inquiries within 2 business days.