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Glenmont, NY, USA, 12077
Literature Request Form

_Dealership Name


_Contact Person


_Address


_City


_State


_Zip Code


_Phone (required)


_FAX Number


_Email (required)


_Mailings

Yes_No Do you wish to receive our
mailing offers & promotions?

_Please select the literature you wish to receive:
J&D Walter 2003-2004 Catalog of Products
J&D Walter Price List
Only after your dealer application has been approved
Current Sales Flyer
Current Stocking Programs


How did you hear about us?
Printed Advertisement - Specify
Internet Search - Specify Search Engine
Another dealer - Specify
Other - Specify


Survey
(These optional questions will help us give you a better service)

What is your type of business? (check all that apply)
Franchise__ Repairs__ ATV__ Watercraft__ Accessories
Others - Specify

If franchised, what brand(s) of motorcycle, ATV or snowmobile do you carry? (check all that apply)

Motorcycle:
Honda
Kawasaki
Suzuki
Yamaha
Triumph
Ducati
BMW
Harley
Other:
ATV /Offroad:
Honda
Kawasaki
Suzuki
Yamaha
Arctic Cat
Polaris
KTM
Bombardier
Other:
Snowmobile:
Arctic Cat
Polaris
Yamaha
Ski Doo
Bombardier
Other:

Do you stock accessories?
Yes
_No

If yes, what is your dealership’s primary focus? (check all that apply)
Leather Apparel__ Textiles__ Gloves__ Helmets
Boots__ Other - Specify

Which of the following brands do you carry? (check all that apply)

Leather:
Zero-60
Joe Rocket
First Gear
Belstaff
Technic
Vanson
Fieldsheer
Other:
Textiles:
Zero-60
Joe Rocket
First Gear
Belstaff
Technic
Hein Gericke
Fieldsheer
Other:
Gloves
Zero-60
Joe Rocket
First Gear
Alpinestars
Technic
Olympia
Tour Master
Other:
Helmets
Arai
Bell
HJC
Nolan
Shoei
Zeus
THH
Other:

How do you prefer to do your ordering?
Online__ In store via company sales rep.
On the phone with sales rep.__ No preference


Comments and suggestions:
Send us any comment or suggestions. Listening to our
customers helps us greatly to improve our services.

_