Rep Request Form

	Sales Rep Information Form Thank you for your interest in representing MUSE and becoming a part of our rep family. Please take a few moments to complete the the below form designed to assist us in selecting reps most compatible with our line, and to help ensure lasting, successful and mutually rewarding partnerships. Please feel free to also email or fax a copy of Resume/Bio and your Line List, in order to expedite the screening process. We look forward to learning more about you!
			*All fields must be completed.
	Your Name:		First: Middle: Last:
	Name of Your business or DBA:		Type: Sole Prorietor LLC LLP .Corporation
	Your Website:		http://www.
	Your Email:
	Physical Street Address: (No PO box address please.)
			City: State: Zip:
	Office/Landline #:		Land Area Code ( )
	Cell Phone #:		Cell Area Code ( )
	Are you a Full-time or Part-time Rep?		Part-Time . Full-Time
	How long have you been a gift rep?		Yrs.
	Do you have another business besides your rep business?		YES . NO If "Yes", please describe:
	Do you have any Sub-reps?		YES...NO If "yes", are your sub-reps Part-Time .Full-Time Both ...
	Sales Territory Covered (including sup-reps):
	How often do you visit these accounts?		Indicate # of visits per month/per quarter.
	Do you exhibit at any trade shows?		YES .NO .If "yes", please list shows & dates below: .
	Do you do any advertising/promotion?		YES .NO Please describe (i.e.: Newsletter, email broadcast, print ad, website, etc.:)
	Which product lines do you currently represent? *Required.		NOTE: In lieu of listing your lines in the below fields, you may email or fax us your Line List.
	Additional Information and/or Comments:
	Please click button to send:

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