SAVE SPACE - SAVE MONEY

DISTRIBUTOR APPLICATION FORM

Application to become a distributor of SPACE Storage Systems



As part of our growth strategy we are willing to negotiate distribution rights per country per industry sector in Southern Africa and per region within South Africa. The Potential distributors must demonstrate their ability to constructively contribute towards the SPACE Storage Systems distribution and networking objectives by completing the following application form.

Application done in the name of:
Title (Dr, Mr, Mrs, Prof etc):
First Name:
Surname (Family Name):
Age:
Qualifications:
Nature / Type of  existing business:
Business performance, achievements and track record:
Position in your company:
Name of  your company:
Company registration number:
Website Address:
Email Address:
* 
Repeat Email Address:
*  
Office Tel:
Please prefix National dialing code
eg +27 for SA, ie +27 (0)12 653 1234
Mobile Tel:
Please prefix National dialing code
eg +27 for SA, ie +27 (0)82 123 4567
Postal Address:
Postal Code:
Street Address:
Postal Code:
Would financing be required for the purchase of the distribution rights?:
For which Southern African country or for which region within South Africa would you be interested in being appointed as a distributor?:
Sector for which you would you be interested in being appointed as a distributor?:
If OTHER please specify:

Designed & hosted by AiNet Internet Marketing


      © 2011  SPACE STORAGE SYSTEMS   -   Design   © 2011   AiNet Marketing CC