Seeking Representation

Name:

Title:

Email:

Phone:

Referred by:

Website:

Company/Brands Seeking Representation:

Please Describe Your Value Proposition And/Or Your Key Points Of Differentiation:

Strategic Growth Needs:

How are you Funding Growth?

Please Describe Your Current Internal Sales Organization:

Distributor Channel Annual Revenue, National:

Direct Channel Annual Revenue, National:

ACV Natural Channel [ex: Whole Foods Market, Sprouts, Fresh Thyme, NCG, etc]:

ACV Specialty/Conventional Channel [ex: Kroger, Albertsons/Safeway, Publix, etc]:

My Agency Network is:

Kehe Authorization:

UNFI Authorization:

Coverage Needed:

ACV Specialty/Conventional Channel [ex: Kroger, Albertsons/Safeway, Publix, etc]:

We must receive samples in order for your line to be reviewed. Please ship a representative set of SKUs to the following address:

C.A. Fortune
Attn: Business Development
1831 Howard St, Unit A
Elk Grove Village, IL 60007