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Particulars form for appointment of new Distributors / Dealers / Retailers

Email *

How did you come to know about us? *

Sugandh India Expo 2024

Incense Media

Local Vendor

Social Media

Google Search

Other

Other:

Required

I am interested in *

Distributionship

Dealership

Retailership

Required

Name of the Firm
*

Address of the Firm
*

GSTIN (if any)

Contact Person
*

10 Digit Mobile Number
*

10 Digit Alternate Mobile

Email Address

Population of the Town
*

Less than 1 Lac

1 - 5 Lacs

5 - 10 Lacs

10 - 20 Lacs

Above 20 Lacs

Total Number of Working Outlets
*

Less than 15

15 to 20

25 to 40

40 to 60

60 and Above

Local Media for Advertisement
*

Local Cable TV

Newspaper

Regional Channel

Hoardings and Banners

Others

Other Brand(s ) you are working with
*

Any Other Information (Optional)

Undertaking

I hereby undertake that all the information given by me as above is true according to my best belief. After my appointment, if any information is found be false or misbehave or misconduct, company's decision will be final and my services can be terminated at any time without paying any compensation to me.

Agree
*

I Agree

Required

A copy of your responses will be emailed to the address you provided.

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