APPLICATION FORM TO BECOME DISTRIBUTOR OF CHEMICAL RESOURCES



Name of the Applicant
Name of the Company/ Firm
Address
Email
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
Name of Company Year To
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.