Thank you for your interest in 5-Hour Energy. The company you represent is being considered for a potential distributor/export partnership into our growing international market. We are seeking motivated, established companies to expand our reach into new marketplaces. Please answer the following questions about the company you represent and your interest in 5-Hour Energy.

First Name*

Last Name*

Title*

Company Name*

Address*

Phone Number*

Email*

Please specify the market/region in which you are interested to be a distributor, wholesaler or retailer of 5 Hour Energy?

Describe the channels you currently operate (Convenience, Pharmacy, On Premise etc.)

Please list the brands that you represent.

Are you importing any other brands into your market?
 Yes No

Why do you think your company would be a good fit to work with 5-Hour Energy?