Distributor Application Form

A. Basic Business Information

Full Name of Applicant *

Business / Company Name *

Type of Business *

Year of Establishment *

PAN Number (Optional)

GST Available? *

B. Contact Details

Mobile Number *

Alternate Contact Number *

Email Address *

Registered Business Address *

Country *

State *

City / Town / Village *

Pincode *

C. Distribution Interest Details

Interested Product Category *

Territory Interested In (City / District / State / Country) *

Expected Monthly Order Volume (Approx.) (Optional)

Preferred Mode of Distribution *

D. Business Experience & Infrastructure

Years of Experience in Distribution / FMCG / E-commerce *

Existing Brands Currently Distributed (Optional)

Number of Retailers / Dealers Covered (Optional)

Warehouse / Storage Facility Available? *

Approx. Storage Capacity (Sq. Ft.) (Optional)

Sales Team Available? *

E. Financial & Compliance Details

Investment Capacity for Initial Stock *

Bank Name (Optional)

Account Holder Name (Optional)

IFSC Code (Optional)

F. Marketing & Growth Support

Ability to Invest in Local Marketing? *

Marketing Channels Used (Optional)

Retail Promotion In-store offers & branding

Digital Marketing Social media & online campaigns

Influencer / Local Ads Local visibility & awareness

Expected Support from Company Optional

Marketing Materials Posters, banners, stands

Training Product knowledge & selling support

Credit Support Flexible payment guidance

Lead Generation New distributor opportunities

G. Declaration & Agreement

How did you hear about our brand? *

Why do you want to become our distributor? (Short Answer) *

Do you agree that distributorship does not provide ownership or monopoly rights over the brand? *

I hereby declare that the information provided above is true and correct to the best of my knowledge. *

H. Upload Section (Optional but Recommended)

GST Certificate *

Upload Limit: 2 MB | jpg, jpeg, png

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MSME Certificate *

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PAN Card Optional

Accepted: jpg, jpeg, png, pdf

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Business Address Proof Optional

Accepted: jpg, jpeg, png, pdf

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Cancelled Cheque Optional

Accepted: jpg, jpeg, png, pdf

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