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Application for Local Distributorship

Please fill up the form below to apply for a Wholesale/Retail Distributorship of our products. For benefits of Distributorship and to learn more please visit our Wholesale Distributors page.

    Reg. Company/Business Name

    Year Incorporated/Regd.

    Reg. Office Address (Including Street, City, State, and Zip)

    Country

    Email

    Office Phone

    Fax

    Website (you may use a comma to separate multiple webpages)

    Authorised Person

    Full Name

    Contact Phone/Mobile

    Products Interested In

    Product

    You may select multiple products.

    Product Market Coverage (geographical Area - eg. State/s,region/s or a country)

    Your market coverage. Being a distributor for a territoty allows you to resell our products (wholesale or retail) to customers in your defined coverage. Additionally any customers who come in our contact and who are based in your territory will be redirected to you.

    Your application will be submitted for processing after you click the submit button. Your distributorship is not confirmed until you receive a application success email. If successful, we will send you documents and further steps via email or your preferred contact method.