Export.gov - Share Your Export Success With Us

Please complete the following to assist us in our efforts to continually improve the quality and effectiveness of the various export assistance programs and services. Reporting our performance lets us stay in business and continue to assist you. Thank you!

The information you provide will remain confidential and will only be reported in aggregate with all successes from the country. We realize the sensitivity to releasing sales figures and are happy to receive generalized estimates or ranges.

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

Company Profile
Year company was established:*

Type of company*:
Manufacturer Distributor Export trading company	Service Other
Sales Method:*
Direct Agents Distributors	Joint Venture Other
If you are not a manufacturer, do you or your firm have documented right to export the product or service?
Yes No Not applicable
*Is your product/service at least 51% U.S. content?
Yes No
Percentage export:

Total annual sales:*

Number of employees in the company:*

Do you have an export promotional budget?
Yes No
Please select your industry:*

Company Background*

Export Description
Did you make your first ever export sale in the past 12 months?*
Yes No
Have you appointed agents or distributors abroad?*
Yes No
Export experience/objective*
New to export New to market Increase to market
Countries you did export to*

Amount of export sale* Please specify the approximate amount in USD (whole numbers only).

How did our office assist you?