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.
Address:
Postal
code:
City:
Country:
Telephone:
Fax:
E-mail:
Web:
Description of Company / Organization:
You are:
Distributor
Agent / representative
End user (laboratory, hospital fertility / reproduction
center)
What
are the products lines?
Date started business:
Annual
sales volume:
Sales area:
Total
number of agents in sales department:
Years of experience
distributing medical, reproduction, 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 customers:
Potential number
of
equipments you may sale:
Comments and suggestions
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.
