Acquah's Enterprise
Authorized Acquah's Enterprise Dealer Application
Email address *
Company Name: *
Contact Name: *
Address: City: State: Zip: Country: *
Phone: *
EIN: *
Which best describes your business? *
Required
How long have you been operating?
How much are you ready to invest in this business? *
Do you have owned vehicle for distribution? *
If no what are your plans? *
Distributor’s Authorized Representative / Manager’s particulars *
Phone Number: *
Address: *
Signature *
IMPORTANT: what area do you intend to cover as a distributor / sub distributor *
What areas do your wholesaler / sub distributor / customers cover?
Do you have financing arrangement with any financial Institution? *
Average monthly turnover for the part six months? *
Date: *
MM
/
DD
/
YYYY
Signature: *
A copy of your responses will be emailed to the address you provided.
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