Membership Application

Apply to join the Clean Urban Living retail marketing program

Contact Information

First Name *

Last Name *

Title *

Phone *

Email *

Products & Services

What is your Primary Product or Service? *

What markets do you service? *

Who manufactures your products? *

Do you offer warranties on your products? If so, what do they cover and for how long? *

Sales & Operations

How large is your sales department and/or dealer network? *

How are you currently generating leads? *

How many additional installs can you handle comfortably every month with your current staff? *

Monthly Sales Revenue *

$10,000-$50,000

$50,000-$150,000

$150,000-$300,000

$300,000+

Are you currently running or have you in the past ran a retail lead gen program? *

If yes, explain those experiences *

How many retail locations are you able to staff and operate right now? *

Additional Information

State any other reasons you feel your company would be a great fit for the program. (Optional)

Review the Terms and Conditions and Membership Agreement before making a membership or program payment. Payment constitutes acceptance of those terms; no separate signature is required. Submitting this application alone does not constitute acceptance or authorize a charge. Member-specific pricing is provided separately in your Deal Terms Schedule, and location approval remains subject to CUL's written approval.

Membership Application

Company Information

Contact Information

Products & Services

Sales & Operations

Additional Information