First Name

Last Name

Company Name

Address

City

State Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon

Country United States Canada

Postal Code

Email Address

Phone Number

Role Owner/PrincipalComfort Advisor/SalesMarketing/AdvertisingServices/InstallationPurchasingWarranty ProcessingOther

Have you worked with Lennox in the past? YesNo

What brand(s) are you currently carrying? AlliedAmanaAmerican Standard HVACArmstrongBryantCarrierDaikinGoodmanNordineRheemRuudTraneYorkOther

What is your estimated annual HVAC purchase value?

How many trucks does your company have?

What is your total number of employees?

Please rate your interest level I want to become a dealer todayI am looking to become a dealer in 3- 6 monthsI am looking to become a dealer in 7-9 monthsI am looking to become a dealer in the next 12 monthsI'm researching suppliersI'm interested in Lennox Parts & Supplies

What is the biggest need in your operation? Providing my customers with affordable optionsGrowing, managing or running my businessCreating a marketing strategy and advertisingTraining my Comfort Advisors / Sales teamTraining my technicians and contractorsEngaging with Big Box Retail Opportunities

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