Become a Dealer Please complete the application below. Fields marked * are required. Do not fill this field 1) Company Information Legal Company Name * Trade Name (if different) Website Year Established * Business Type * Select… Corporation LLC / Ltd. Partnership Sole Proprietorship Other Tax / BN / VAT # # of Employees Annual Revenue (approx.) Warehouse / Stocking? * Select… Yes No 2) Primary Contact First Name * Last Name * Title / Role Email * Phone * 3) Business Address Street Address * Address Line 2 City * State/Province * Postal/ZIP * Country * 4) Territories / Markets of Interest Select all regions where you intend to sell/support. Canada USA UAE Saudi Arabia Qatar Bahrain Kuwait Oman Jordan Other If “Other”, specify 5) Product Lines & Capabilities Products of Interest (select all that apply) Ecology Units ESP Kitchen Purification Systems CRAC / Data Center AC Ductwork & Accessories Spare Parts & Consumables Estimated Monthly Volume Typical Order Value Target Start Date Capabilities (select all that apply) Sales & Marketing Design & Customization Installation Testing & Commissioning After-Sales Service / Warranty Local Stocking Existing Brands You Represent Licenses / Certifications Insurance Coverage Select… Yes No Insurance Details 6) Trade References Provide at least one recent supplier or customer reference. Reference 1 – Company * Contact Name * Email * Phone Add more references (optional) Reference 2 – Company Contact Name Email Phone Reference 3 – Company Contact Name Email Phone 7) Documents Upload Attach any relevant documents (company profile, trade license, tax certificate, certifications, brochures, etc.) Additional Notes 9) Declaration I consent to CANATAL contacting me regarding this application. * I confirm that the information provided is accurate and agree to the Dealer Terms & Conditions. * Authorized Signatory (type your full name) * Date * Submit Application By submitting this form, you acknowledge that CANATAL may review, verify, and contact the references provided.