Reseller Registration
The Scewo wheelchair is only a prototype and can not be sold yet.

If you are interested as a reseller / distributor please fill out this form so we can contact you when it is the right time.

Many questions are not compulsory and can be left blank if you don't want to answer it. However, by filling out all questions we can get a better picture of you and this will of course raise your chance to become a future reseller.

Thanks for your efforts!

Email address
Company Name
Your answer
First Name
Your answer
Last Name
Your answer
Website
Your answer
Country
Your answer
Do you already have customers interested to buy a Scewo?
If yes, how many?
Your answer
Please tell us in one sentence, why you think you would be the ideal partner to sell Scewo in your region.
Your answer
Can you cover the whole country?
Next
Never submit passwords through Google Forms.
This form was created inside of Scewo. Report Abuse - Terms of Service - Additional Terms