Distributor Application Form

Company General Information    
Company Name
:
Mailing Address
:
Postal Code
:
City
:
Country
:
Tel
:
GSM
:
Fax
:
E-mail
:
Web page
:
Type of Business
:
The companies&products that you represent
 :
Do you sell Boiler?
:
Yes No
If you do, please write down
:
If you do, how many boiler did you sold last year?
1-50 51-100 101-250 251-500 501...
Showroom Capacity (M2 )
:
   : is owned is rented
Storage Area (M2 )
:
  : is owned is rented
Your comments
:

You will be informed as soon as possible

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