Fields marked with * are required.
OMB Control No.: 0625-0237
Expiration Date: 4/30/12

Contact Information

Company Name:*  
Salutation:  
Full Name:*  
Title:*  
Address:*  
City:*  
State:*  
Zip Code:*  
Telephone:      Ext.
Fax:  
Cell Phone:  
Email:*      Receive a Copy
Confirm Email:*  
Web Site:  


Meeting Details  

Available to Meet in Our Commercial Service/US Dept of Commerce Office in Cleveland?*
Yes    No  

Preferred Time of Meeting:*
Also indicate if you would prefer a specific meeting time at our office

Have you previously tried to export to Canada?
Yes    No  


Please Describe the Products you are looking to sell to Canada:


I am currently looking for representation in Canada
Yes
No
Prefer Direct Sales
 

Countries in N America to which we are now exporting from US

 

 

Your Local U.S. Department of Commerce Office
Are you currently working with one of our offices/U.S. Export Assistance Centers in the United States?*
Yes    No  

If yes, which office or Trade Specialist are you currently working with:
 

In the past 24 months, have you or your company utilized any market research reports or trade promotion programs, or received counseling from the U.S. Dept of Commerce or one of its U.S. Export Assistance Centers?*
Yes    No  

If yes, has the program of information provided assisted you in completing your export sales?
Yes    No  

If time allows, could you please explain?

 

  

Public reporting for this collection of information is estimated to be 5 minutes per response, including the time for reviewing instructions, and completing and reviewing the collection of information. All responses to this collection of information are voluntary, and will be provided confidentially to the extent allowed by law. Notwithstanding any other provision of law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB control number. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Reports Clearance Officer, International Trade Administration, Department of Commerce, Room 4001, 14th and Constitution Avenue, N.W., Washington, D.C. 20230.