Company Name*

Address*

City*

State*

Zip Code*

Company Web Site 

First Name of Company Rep(s) Attending Event*

Last Name of Company Rep (s) Attending Event*

Title 

Telephone No*

Contact Fax 

Email*

First & Last Name of Alternate Contact (or person completing this form) 

Alternate Contact E-mail 

Alternate Contact Tel 

Name*

Relationship to Company Representative*

Phone or Cell Phone*

Option A 

I am interested in registering for the Option A (Trade Winds Forum - The Americas Business Conference, Private Consultations with Senior Commercial Officers and Business to Business Matchmaking Sessions in Brazil) Cost: $1950.00 for small companies, $2850.00 for large companies.

Yes No

Option B 

I am interested in registering for Option B (Trade Winds Forum - The Americas Business Conference and Private Consultations with Senior Commercial Officers) Cost: $850.00

Yes No

Company Activity*

(Select all that apply)

Manufacturer	Service Company
Exclusive Distributor	Franchisor
Export Management Company	Other

If other, please specify 

Has your firm ever used the Gold Key Matching Service or other Commercial Service Program?* Yes No

Type of Service Used  Gold Key Service International Partner Search International Company Profile Other

Date of Service Used 

Location (Country) of Service Used 

Are you currently working with your local U.S. Commercial Service office (U.S. Export Assistance Center - USEAC)?* Yes No

If yes, please provide USEAC City and Trade Specialist name 

HS Code (if known) 

Does your product contain at least 51% U.S. content?* Yes No

Describe the product/service(s) you seek to promote*

Please include its competitive advantages and unique selling proposition. Includes its applications and unique features that differentiate your product from the competition.

Who are your major competitors at home and abroad?*

List the most important end-users or end-user industries for this product/service.*

How is your product typically distributed and marketed in the United States (and in other countries if applicable)?*

What type of licensing or registration does it require in the U.S.?*

What related products might an agent/distributor of this product also handle?*

Are you currently doing business in Brazil?  Yes No

If yes, please explain the nature of your current business in Brazil (direct sales, agent/distributor agreement, etc) and why you are seeking additional business contacts in the market (current rep/partner not performing, seeking new market, etc.). 

If you have a representative/partner agreement already in place in Brazil, is this arrangement exclusive?  Yes No

If applicable, please provide the contact information of your current representative/partner in Brazil. 

Is your representative/partner aware you are seeking additional representation?  Yes No

Now that we have an idea of your current business in Brazil, please give us a brief description of your overall strategy and what you are generally hoping to achieve on your trip to Brazil. 

What type of business contacts are you seeking to identify on this trip to Brazil for Trade Winds Forum - The Americas? 

Distributor/Wholesaler	Joint Venture Partner or Licensee
Agent/Sales Representative	Direct Sales
Franchisee	Other

Is your firm seeking representation on an exclusive basis in this market?  Yes No

Describe any preferences, requirements, or pre-qualifications that the ideal prospects must have. 

This includes English language ability, size, revenue, coverage, client base, investment, etc.

Describe any special feature of your company's operations, interests, or objectives in the target market that can help us identify potential business partners. 

Are there any specific companies, or types of companies, you would like us to contact? If so, please name them. 

Are there any specific companies, or types of companies, you would NOT like us to contact? If so, please name them. 

If you are interested in a possible Spin Off Gold Key Matching Service, please indicate the country(ies) of interest 

The Gold Key Service is a customized service for finding potential agents, distributors, sales representatives, and other business partners. (Additional fees will apply).

If you are unsure of a possible Spin Off Gold Key country or would like us to assist with your market strategy in other Western Hemisphere markets, please check the box below.  Please contact me to discuss strategy and possible spin-off Gold Key.

Senior Commercial Officers from the following Western Hemisphere markets will be available for private consultations*

Please check countries in which you would like a meeting.

Argentina/Uruguay	Costa Rica	Mexico
Brazil	Dominican Republic	Panama
Canada	Ecuador	Peru
Chile	El Salvador	Venezuela
Colombia	Guatemala

Please list in priority order the countries that are of interest to your company.*

This list will be used to customize your private meetings with our Senior Commercial Officers. Each appointment will last 20-25 minutes.

Are you currently doing business in any of the above selected countries? If yes, please list and briefly explain. 

Please list any questions or comments for the Officers. 

Note: These questions will be sent to our Officers in advance and will help them to prepare for your meeting.