Distributor Information Form

Tell us a little about your business by filling out the following form. Click the Submit button to send us your information.

Fields marked with ' * ' are mandatory

Contact information:

First Name:	*	Last Name:	*
Company Name:		Address:
City:		Zip:
Work Phone:		Fax:
E-mail Address:	*

Office Information:

Office Premises:	Own    Rental
Type of Relation:	Owners    Partners    Directors
Sales Turnover:	(US $ P.A.)
No. of Employees:
1) Office:
2) Sales:
Warehouse Area:	(sqft.)
Transportation:	Own Truck    Logistic Companies
Product Lines Handled:
Own Brands (If Any):
Manufacturer's Represented:
Coverage:
Market Potential:
1) Auto: (Qty/Value):
2) Building: (Qty/Value):
Expected Annual Off Take:
Bankers A/C No. & Address:
References:
Preferred Payment Terms:
1) Advance Remittance / LC:
Preferred Port:

1) What is the nature of your business?

Manufacturer	Distributor	Dealer
Retailer	Installer	Trader
Other	Other:

2) What products are you currently dealing in?

	Llumar		Vista		Formula 1
	3-M		Madico		Sun Guard
	Johnson		Solis	Other:

3) From whom are you currently buying?
4) Number of years in Business:
5) Years in Window Film Business:
6) Annual Film Purchases in US $:
7) Estimated Annual Film Purchases from us in US $:

Primary business:

Automotive

Residential

Safety

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If Others, please specify:
Any other comments?