Interested in becoming a distributor?

>>Interested in becoming a distributor?
Interested in becoming a distributor? 2017-10-05T17:04:43+00:00

Should you be interested in distributing our products, we would appreciate your furnishing us with information on your company in the form provided below.

This information will help us to know you better and enable us to adjust our offer to your exact needs.

Distributor request

Company name

Contact person

Position

Address

Postal code

City

Country

Telephone

Fax

E-mail (required)

Web

Company / Organization

What are the products lines?

Date started business

Anual sales volume

Sales area

Total number of agents in sales department

Years of experience distributing medical and fertility products

How do you promote new products?

What products do you mainly distribute?

Line of product 1

Products

Brand

Country of origin

Date started representation

Line of product 2

Products

Brand

Country of origin

Date started representation

Line of product 3

Products

Brand

Country of origin

Date started representation

Information about your market

Potential number of final costumers

Potential number of equipments you may sale

Comments and suggestions

I accept the Data Protection Policy

Our privacy policy complies Data Protection Directive 95/46/EC of the European Parliament and of the Council on the protection of individuals with regard to the processing of personal data and on the free movement of such data: Computer Contact will not sell or rent your personally identifiable information to anyone.

You can also contact us:

Tel: +34 934192910

Fax: +34 934199426

www.micropticsl.com

micropticsl@micropticsl.com