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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