Distributorship Application

Name of the Applicant

Name of the Company/ Firm

Address

Phone No.

Level at which you can become a Distributor

District LevelState LevelLocal (For you locality)

Do you have any experience in Distribution?

YesNo

Brief History of the Distribution of the Products you have done so far/ Details of your present Business.

Name of the company for whom you have done distribution

Last One year Turnover (INR)

Investment Capacity (INR)

NOTE:
1. The information given in this form would not used anywhere and would be highly confidential.