Distributors - Dietz & Watson

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last name*

company*

email address*

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Are you a U.S. citizen?

Have you ever been convicted of a crime?

Do you currently have any felony charge pending against you?

Where did you hear about us?

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Have you ever worked for Dietz & Watson before (either directly, through a temporary agency, or for a distributor)?

Did you attend college?

What was your field of study?

What is you current occupation?

Do you currently own a business?

Do you have liquid capital available?

In which state(s) are you interested in pursuing a Dietz & Watson Distributorship?

Explain why you are interested in becoming a Dietz & Watson Distributor and why you think you would be successful*

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