Distributor Registration Form
Distributor Registration Form
Please fill out this form to register as a distributor and begin your partnership with us.
Personal Information
Name
Business Name
Address
Phone number
Business Information
Type of Business
Years in Business
Website (if applicable)
Tax Identification Number
Product Interest
Please list the products you are interested in distributing
Terms and Conditions
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You confirm that all information is correct.
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You will only distribute [Your Company Name]'s products in the agreed region.
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You will follow our pricing rules and pay on time.
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You handle product delivery after we send it.
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Either party can end this agreement with notice. Return unsold products within 30 days.
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Keep all shared business information private.
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I agree to the terms and conditions outlined for becoming a distributor.
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I understand the responsibilities and expectations of the distributor relationship.
Signature
Name:
Date:
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