AgriEyes Distributor Application Form

Personal Information:

1. Full Name:

2. Company Name (if applicable):

3. Contact Number:

4. Email Address:

5. Street Address:

6. City:

7. State/Province:

8. Zip/Postal Code:

9. Country:

Business Information:

10. Years of Experience in Distribution:

11. Nature of Business (e.g., retail, wholesale, online):

12. Website (if applicable):

13. Briefly describe your current product line(s) and target market:

Distribution Details:

14. Are you currently distributing similar products? If yes, please provide details:

15. How do you plan to promote and distribute AgriEyes products in your market?

16. What differentiates your distribution business from competitors?

17. Have you ever been a distributor for another brand? If yes, please provide details:

18. Are you able to meet the minimum order requirements for AgriEyes products?

19. Are you interested in exclusive distribution rights for a specific territory? Please specify:

Additional Information:

20. Why are you interested in becoming a distributor for AgriEyes?

21. How did you hear about AgriEyes?

Please attach any additional documents or information that you believe would support your distributor application.

Declaration:

By submitting this application, I confirm that the information provided is accurate and complete to the best of my knowledge. I understand that AgriEyes reserves the right to accept or reject distributor applications at its discretion.

Signature: ___________________________________________

Date: _______________________________________________

Please email the completed application form to distributors@agrieyes.com or submit it online through our distributor portal.

Thank you for your interest in becoming an AgriEyes distributor. We will review your application and get back to you shortly.

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