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Application Form for Distributionship :

Name of the Firm :
Postal Address :
Tel No :
Fax :
E-Mail :
Nature of Firm :  Proprietory              Partnership

 Pvt.Ltd                       Public Ltd
Date of Establishment :
Key Person to Deal with :
Name of Banker :
Address of Banker :
Local ST NO :
Central ST NO :
Annual Turnover :
Expected in Current Year
Last Year
Previous Year
Rs. Lac
Type of Business presently being handled :
Manufacturing
Distribution
Trading
Wholesale
Import / Export
Others

Your Distribution Set Up :
No of Textile Units in your Area : Email it as an attachment
List of Existing Customer : Email it as an attachment
Geographical area being covered by you :
Which Geographical area would you like to represent Chemax products ? :

Your Infrastructure :
Office space (sq ft) :
Godown Location :
Godown Area (sq ft) :

No of Staff :
Sales Persons :
Accounts :
General :
Transport Co. Preferred by you :
Remarks (if any):
      
CHEMAX MULTIKOTES (INDIA) PVT.LTD. © 2004.