CHANNEL PROFILER- DISTRIBUTORSHIP FORM
Prospective Distributor Introduction Form
Enterprise Data
Name *
Address *
Full Postal Address (Official)
Contact # *
Landline with STD Code
Entity Nature *
Financial Data(Enterprise Sales Turnover) *
Last Financial Year (Audited)
Business Data
List the companies( brands) you are dealing with currently? *
What is the product range you are dealing in? *
Territories Covered *
Segments Covered *
Private Segment
Required
Segments Covered *
Government Segment
Required
Organization Data
Promoters Data( Name,Qualification, Contact # , Email ID) *
Employer Strength # ( Sales, Servicing) *
Opportunity Data
What Brands you are interested in? *
Required
What Products you are interested in? *
Eg: Waldmann Derung-Hospital Lights- Emergency/Minor OT/Mobile
Required
Submit
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