Distribution Inquiry

Thank you for your interest in our H2O^® Wireless products and services.
Please complete and submit this form below. One of our H2O^® Wireless Sales Managers will be in contact shortly.

All fields required
Contact Name
Company Name
Mailing Address
City
State, Zip Code	,
Phone Number	( ) -
Email Address
How long have you been in business?
What types of products and/or services do you offer?	POSTPAID Wireless PREPAID Wireless POSTPAID broadband PREPAID broadband GSM handsets CDMA handsets Handset accessories AT&T and/or GoPhone Verizon and/or Unleashed/Verizon Prepaid Virgin Mobile Boost Mobile Simple Mobile Tracfone/Net10 T-Mobile and/or T-Mobile 4G Sprint Clearwire NON-Wireless
How many activations/renews per month on carriers serviced?
Please choose your method of distribution	Retail Wholesale Online other
How many retail locations do you support?
Are you currently a Locus distributor or dealer?	Yes No
Select Plan	H2O MONTH (Unlimited Talk & Text) H2O MINUTE (Pay as you go) H2O DAY (Daily Access) H2O Broadband (with Int'l Roaming) H2O Bolt H2O Family Plan All H2O plans
Additional Comments (limit 200 characters)
Best time to reach you	Morning Afternoon Any Time

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