Distributor Application Form Solareks Solar Water Heating System

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