DISTRIBUTOR APPLICATION FORM
Be a part of our fast growing Network. We pride ourselves in building strong relations. Join our group of Distributors and get the opportunity to present more options to your customers.
Name / Address |
|||
Company |
|
Address 2 |
|
Address |
|
City |
|
Country |
|
Postal Code |
|
Phone No |
|
Fax |
|
|
|
Website |
|
Contact person |
|
Designation |
|
|
|
DID |
|
Distributorship Application:
Company Info |
|||
Biz Size of company |
1-5 6-10 10-20 20-50 50 and above (Circle one) |
||
Sales Rep (Total) |
1-5 6-10 10-20 20 and above (Circle one) |
||
Inside Sales Rep |
1-5 6-10 10-20 20 and above (Circle one) |
||
Geographical coverage |
(List all relevant states, countries or regions with people on the ground) |
||
Brands you are currently representing |
(List all brands represented) |
Products of interest |
|
Geographical area(s) of interest |
|
Describe your target base (in brief)
|
|
Top 4 customers |
1 2 |
3 4 |
|
Marketing Strategies (in brief) |
|