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Distributorship Form
Section 1: Company Details and Gacacaeneral Information
Name of Company :
Street Address :
Postal Code :
City :
Country :
P.O. Box and Mailing Address:
Tel : Fax :
Email : WWW Address :
Contact Name and Title :
Email :
Parent Company :
(Full legal / officially registered company name)
Subsidiaries, Associates - name, city, country : (attach a List if necessary)
International Offices/Representation:
(Countries where the Company has local Offices/Representation)
Type of Business : (Mark one only)
Corporate/ Limited Partnership Other (specify)
Nature of Business :
Manufacturer Authorized Agent Trader
Consulting Company Other (specify)
Year Established : Number of Full-time Employees :
License no./State where registered : VAT No./Tax I.D :
Technical Documents available in :
English  French Spanish
Russian Arabic                Chinese
Other (specify)
Working Languages :
English  French Spanish
Russian Arabic                Chinese
Other (specify)
Total Number of tears of operation :
Name of Company working with :
   
Section 2: Financial Information
Annual Value of Total sales for the last 3 years :
Year 2012: Amt Year 2013: Amt Year 2014:Amt
Annual Value of Export sales for last 3 Years:
Year 2012: Amt Year 2013: Amt Year 2014:Amt
List below up to a maximum of fifteen15 product Sales/Services offered :
Code Description (one Line for each Item) National/International Quality Standard
to which Item conforms