Federal Signal Smoke Signal Fire Alarms - Distributor Registration

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Distributor Application
To qualify for distributor discounts please complete the following application.

= Required Fields

First Name

Last Name

Company

Address

City

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select a state or "Outside US/Canada"

Non US
Province/Region

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Zip / postal code

required for US & Canada

Telephone

Fax Number

Note: Fax number required for Non-US orders

Email Address

Please check all that apply
Company Business		Job Function
	Electrical Contracting		Owner, Partner, President, VP, General Manager
	Low-Voltage / Communications		Project Manager, Job Foreman, Supervisor
	Industrial /Commercial / Instutional		Electrician, Journeyman, Technician
	Engineering / Design/ Architectural Firm		Purchasing, Estimator, Inspector
	Utilities / Transportation / Gas / Mining
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