Preferred Dealer Listing Information

Fax Back to Milodon at (805) 577-7540

 

Company

Name ______________________
Address __________________________________________________________________
City ______________________
State/ Province _________
Zip / Postal Code __________
Country ______________________
Local Phone # ______________________
Toll Free Phone # _______________________
Fax # ________________________
Owner ____________________________________________
Sales Contact Person ____________________________________________
Contact Person's Title ____________________________________________

Primary Type Of Outlet

Retail Chain Store _________________________
Traditional, Non-performance Jobber _________________________
Performance Speed Shop _________________________
Engine Builder / Machine Shop _________________________
Other _________________________

List 2 Primary WD Sources

1. ___________________________________________________
2. ___________________________________________________

Outlet Info

Number Of Employees _________________________
Business Started _________________________
Number Of Square Feet _________________________
Annual Sales Range _________________________

List the Types of Advertising Your Outlet Uses

Direct Mail _________________________
Radio _________________________
TV / Cable _________________________
Internet _________________________
Newspaper _________________________
Flyers _________________________
Other _________________________

Milodon Products Stocked

Main Caps _________________________
Timing Chains _________________________
Water Pumps _________________________
Oil Pans - Street _________________________
Oil Pans - Drag Race _________________________
Oil Pans - Circle Track _________________________
Oil Pans - Marine _________________________
Oil Pans - Stock _________________________
Oil Pans - Truck _________________________
Copper Head Gaskets _________________________
Stainless Valves _________________________
Engine Fasteners _________________________
Chrome Valve Covers _________________________