Distributorship Application Form

* Mandatory field which must be filled in.

A. Property
1. Interested Property *
2. Interested Category *
3. Interested Territory *

B. Company Profile
1. Company Name *
2. Contact Person *
3. Address *
4. Tel *
Fax *
email *
5. Established Date: *
6. Staff No:*
7. Bank Information :
Bank Name:
Account No:
Account Name:
8.Type:* Corporation
Private Company
9. Paid-up Capital:

C. Current Sales Information
1. Current Product *
2. Sales Territory *
3. Channels of sales *
4. Sales Amount in Last year:*
a. Local
b. Export (if any):

D. Your Marketing Plan for Marimo Co. Limited Products*


E. Forecast Amount of Purchase From Marimo Co. Limited

in 12 months
Max. US$*
  Min. US$*

Check Code:


PERSONAL DATA PRIVACY
The personal data you provide by means of this form will be used internally by Marimo Co., Ltd. for Distributorship application only.
Copyright © 2009 Marimo Co., Ltd