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Associates Application

Contact Information

Legal Business Trade Name:
Contact Person:
Title:
Mailing Address:
City, State, Zip
Business Phone:
Business Web Site:
Email Address:

Business Information

Showroom:	Yes No
Warehouse:	Yes No
Rent or Own:	Rent Own
Years in Business:
Number of Employees:
Approximate 2007 Sales:

Business Lines

Check All That Apply

Security	Telecommunications	Automation
Lighting	Audio/Video	Networking/IT
Climate Control	Theater	Window Treatments

Top Three Vendors

1.	2.	3.

markets served

Check All That Apply

Residential	Commercial	Educational
Medical	Industrial	Governmental

TERMS

By submitting this application, the applicant certifies that they are a lawful entity doing business within the United States and its territories and wishes to subscribe to CiAlliance. The applicant authorizes CiAlliance to complete the due diligence process. By completing the application the applicant understands that they are not subscribers to CiAlliance until their application has been accepted and all related fees have been paid.