Apply to Be a Distributor | Meridian Lighting Lighting Distributor Application

Company Name*

Address*

City*

State*

Zip Code*

Phone*

Email*

Company Size*

Please choose the option that best describes the number of employees within your company.

Geographical Coverage*

Please list all relevant states, regions, or countries in which you supply.

Goals & Alignments*

Please describe your business objectives and why you are a good fit for Meridian's Distributorship program.

Top 3 Sellers & YTD Quantities Sold Each*

Please list your top three selling items as well as the respective quantities sold (year-to-date).

Top 3 Meridian Items of Interest*

Please list your top three selling items as well as the respective quantities sold (year-to-date).

Affiliates*

Please provide a list of your affiliated merchants and suppliers.

Name

This field is for validation purposes and should be left unchanged.

Distributorship Program Application Form