Distributorship Form

Distributorship Application Form

We are please that your company is interested in becoming our distributor.We are striving to become the leader and the best in our area of specialization.

Company Name

Address:

Certificate of Inc.No:

Date

Tel:

Email:

Name of Managing Director(s):*

Tel:

Next of Kin

Date of Birth:

Email:

Contact Person 1

Designation:

Tel:

Contact Person 2

Designation:

Tel:

How Many Wholesaler/Retailer netwrok do you have?

No of Sales Support staff

Proposed area of Coverage

Proposed amount of Investment

Warehouse Facilities(in sq.mtrs)

Location of warehouse

How close is your Warehouse to the main market?

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