Distributor Application
5 Star Industrial Coatings | Pitch Black Manufacturing Plant
  • How Our Distributor Program Works

    PREMIUM
    • Purchase 6,000+ gallons of Pitch Black per month
    • FREE use of our drop tank for the duration of your distributorship
    • Company logo listed on our distributor scroll
    • Company listed on our distributor map & directory

    STANDARD
    • Purchase less than 6,000 gallons of Pitch Black per month
    • Rental of our drop tank for the duration of your distributorship
    • Company listed in our distributor map & directory

    Either way, we'll deliver the drop tank to you and help you get started. Grow your business on a brand you can trust. Pitch Black is a brand in high demand.
  • How to Apply:

    • Must be completed by the applicant.
    • Fill out this form from top to bottom, fields may change based on answers
    • You'll receive a copy of your form submission to keep on file.
    • Follow up in 1-2 weeks to check the status of your application.

    IMPORTANT - You can save this form to return later, but you MUST save the web link given on the web page after saving. It will not be emailed to you. We do not have access to your temporary data or link saved prior to you completing the application. Copy and paste it for later. Applications can be saved up to 30 days. Data will be lost after 30 days.
  • We'll Review Your Application as Soon as Possible.

    • Our team will email and/or call you.
    • We'll finalize all paperwork.
    • Your distributorship will begin on an agreed upon start date
  • Applicant Info

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  • Make sure this email is correct so we can contact you. A copy of this application will also be sent to this email address.
  • Please enter the address for the state in which you are incorporated.
  • This can be obtained from your Secretary of State's website.
  • (Including your company headquarters)
  • Business Plan

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  • List the cit(ies) and/or zip codes for which you'd like to cover.
  • (Including your company headquarters)
  • List the person that will be running the day-to-day distributorship activities.
  • Trade References

    We may contact any of the companies you list below. Please list three companies you've done business with. These can be suppliers, customers or previous employers.
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  • (Date range i.e. month/yr - month/yr)
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  • (Date range i.e. month/yr - month/yr)
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  • (Date range i.e. month/yr - month/yr)
  • Military Service

  • Thank you for your service.
  • Date range i.e. month/yr - month/yr)
  • Word or PDF Documents Only
  • DISCLAIMER & SIGNATURE

    I certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsify information is grounds for refusing to set up or continue a distributorship.

    At the time of application, I attest that I have the legal right to reside and work in this country (proof required). I understand I must provide a current Business Certificate of Good Standing for my state with this application. I authorize any person, organization, or company listed on this application to furnish you any and all information concerning my previous business experience. I also authorize you to request and receive such information including, but not limited to, any criminal conviction on my record.

    In consideration for this distributorship, I agree to abide by the rules and regulations of the manufacturing company, which rules may be changed, withdrawn, added, or interpreted at any time.

    I also acknowledge that the distributorship may be terminated, or any offer or acceptance of distributorship withdrawn, at any time, by either myself or 5 Star Industrial Coatings, LLC, for any reason not expressly prohibited by law.
  • The Pitch Black sealcoat brand prides itself on ethical business practices, high quality durability, and safe reliable ingredients. Manufacturers, contractors, government agencies and end consumers rely on the safety and integrity of the brand. Becoming a part of the Pitch Black family requires you to help protect those interests.

    Your signature below indicates you understand and agree to all of the above.
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