Become a Distributor Interested in reselling our products? Submit a dealer application to become an authorized dealer of Quest Products. Serious inquirers only. Please complete the following form: Company & Contact InformationCompany Name*Owner Name(s)*Contact Name* Contact Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*FaxWebsite Business Structure*CorporationLLCSole ProprietorOtherYears in Business*Tax IDD&B #Supplemental InformationHow did you hear about us?Describe your customers, type of business, and market(s) servedWhere do you sell your products?*Check all that apply. Retail Store Website eBay Catalog Other What products are you interested in?*Check all that apply. Diagnostic Devices Ear & Nose Health & Beauty Have you or another indirect company affiliation been a dealer/distributor of our products? If yes, include company name.What other products does your company carry?Do you manufacture or private label any products?YesNoDo you provide technical service for any products sold?YesNoWhat is your policy on product returns?What was your annual company revenue last year?*Below US$ 500,000US$ 500,000 - US$ 1 MillionUS$ 1 Million - US$ 2.5 MillionUS$ 2.5 Million - US$ 5 MillionUS$ 5 Million - US$ 10 MillionAbove US$ 10 MillionDo you carry liability insurance? If so, how much in US Dollars?MAP Pricing Agreement The minimum advertised pricing (MAP) for our products and the manufacturer suggested retail prices (MSRP) are shown on the price sheet. Dealers who advertise our products for prices lower than the MAPs may be terminated. By checking the "I Agree" box below, applicant requests consideration to represent and market certain Quest products and applicant agrees that all conversation and proprietary information exchanged between parties will be held in confidence by both parties. Applicant agrees not to sell any Quest products anywhere not selected above.* I Agree Captcha This iframe contains the logic required to handle Ajax powered Gravity Forms.