Dealer EOI Form Home Dealer EOI Form Dealer EOI Form Full Name Email Address Phone Number City State Please Select State NSW QLD VIC SA WA TAS ACT NT Do you currently own a business? Yes No Business Name ABN Industry/Background Please Select Industry plumbing electrical retail sales other Why are you interested in becoming a Pure Line dealer? Do you have experience in sales, customer service, or installation? Yes No Are you looking for: Full-time opportunity Part-time / side business Adding to existing business Approximate budget to start Please Select budget <$5K $5K–$10K $10K+ “Unsure” Preferred Territory / Region Best time to contact you Please Select Time Morning Afternoon Evening Anytime How did you hear about Pure Line? Please Select Google Social Media Referral Event Other “I understand this is an Expression of Interest and not a binding agreement.” “I consent to Pure Line contacting me regarding dealer opportunities.” Register My Interest
