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Membership Application
Apply to join the Clean Urban Living retail marketing program
Company Information
Legal Company Name *
Company Website *
How long has the company been in business? (Optional)
City *
State *
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)
Submit Application
