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Distribution Application

Distribution Network FORM

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FULL NAME *
Home Address *
Email *
Phone
NRIC
Name
Address
Relationship
Phone No
INCOME TAX NO
Do you want join as *
Are you running any business that registered with SSM? ( Yes means upload SSM )
Business Name
Registration No
Telephone
Business Address *
Fax
FB Page
Instagram Page
Website
Are You Currently a Reseller, Stockiest or Doorshiper for any other Brand ? We prefer to tie up with those who have experience in this area. We also look out for those who have experience in sales and marketing. Kindly include as much information which would help us to evaluate if we can appoint you as a Reseller, Stockiest or Doorshiper *
How you hear about us?
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